Medicaid Prescription Drugs: CMS Should Implement Revised Federal Upper Limits And Monitor Their Relationship To Retail Pharmacy Acquisition

January 14, 2014
Medicaid Prescription Drugs: CMS Should Implement Revised Federal Upper Limits And Monitor Their Relationship To Retail Pharmacy Acquisition
In December 2013, the Government Accountability Office (GAO) released a report (GAO-14-68) that addresses questions raised about whether federal upper limits (FULs) calculated using prices published in national compendia can effectively control Medicaid expenditures on drugs subject to the FULs because these prices do not reflect pharmacies’ actual costs for acquiring these drugs. The report looked at the National Average Drug Acquisition Cost (NADAC) and the PPACA-based federal upper limits (FULs). This report (1) describes how . . .