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Tennessee Medicaid Closed Formulary, Capped Spending Experiment Rejected By CMS

 
• By Cathy Kelly

Biden Administration nixes Trump-era plan that would have allowed the state to exclude drugs from coverage even as it collected mandatory Medicaid rebates from manufacturers.

Decision Suggests CMS May Be Skeptical About Oregon's Request To Restrict Drug Coverage In Its Medicaid Program • Source: Shutterstock

The Centers for Medicare and Medicaid Services is withdrawing support for aspects of a demonstration project planned by the Tennessee Medicaid program involving restricted drug coverage and a block grant approach to federal spending, both of which had previously been blessed by the Trump Administration.

In a recent letter to TennCare director Stephen Smith, CMS asks the Tennessee Medicaid agency to “remove the expenditure...

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