Monthly Archives: January 2020

CMS Issues Guidance to States on 340B Duplicate Discounts

Late last year, we noted that the Massachusetts Medicaid program had proposed regulations to address issues related to the prohibition on duplicate discounts in the 340B program.  The Massachusetts solution was relatively straightforward:  for high-cost drugs, Massachusetts Medicaid was going to claim the Medicaid rebate on those drugs itself, meaning that qualifying hospitals could not acquire the drugs under the 340B program.  Little did we know that CMS was also planning to address the same issue,… More

CMS Is Seeking Guidance on Medicaid Coverage for Children Provided Across State Lines

The Medicaid program generally has more generous coverage rules for children than for adults.  For example, under the Early and Periodic Screening, Diagnostic and Testing (EPSDT) provisions of the Medicaid statute, if a child’s medical condition is identified via an EPSDT screening, the state’s Medicaid plan must cover treatment for that condition, even if the necessary treatment consists of an optional benefit under the state Medicaid plan.… More

MACPAC Releases Updated MACStats

Our friends at MACPAC have released the December 2019 edition of MACStats:  the Medicaid and CHIP data book.  MACStats has data and statistics on virtually any aspect of Medicaid and CHIP that you’d care to learn about.  You can find the link to the document here.

The data book has five sections:  key statistics (including Medicaid and CHIP enrollment which, as we pointed out in a post last month,… More