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CMS Allows Medicaid Closed Formulary Without Giving Up Rebates

By John Wilkerson / January 8, 2021 at 5:20 PM
CMS for the first time will let a state exclude drugs from its Medicaid formulary and still keep automatic Medicaid rebates. The closed-formulary policy is tied to a block grant, a GOP-backed policy that many states have no interest in pursuing, but the approval Friday (Jan. 8) of Tennessee’s waiver lays a legal path for states to pursue closed formularies even without block grants. Tennessee requested permission to not cover drugs that receive accelerated FDA approvals until the state determines...


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