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Congressional Republicans Ask CMS to Clarify Changes Required by Health Care Law

Members of the House Energy and Commerce Committee and Senate Committee on Finance today sent a letter to the Centers for Medicare and Medicaid Services requesting an update on plans to change the calculation used to determine reimbursement rates for prescription drugs in Medicaid. The president's health care law requires CMS to revise the formula for reimbursing pharmacies for generic and multiple source drugs in Medicaid programs by using the Average Manufacturer Price, or AMP, to set Federal Upper Limits. Despite the president's repeated promises of transparency, CMS has yet to even issue a notice of proposed rulemaking on the AMP changes in the president's health care law.

The members wrote:

"Predictably, these delays and selective implementation of the law have created unnecessary confusion across the country. Due to the lack of clarity on the AMP calculation, manufacturers, pharmacists, and states have been forced to guess the intent of CMS when performing tens of billions of dollars in calculations. This regulatory quagmire is simply unacceptable, and stakeholders deserve better.

"Unfortunately, CMS' handling of the AMP regulation is just the latest example of this Administration failing to keep those promises. Whether it is bypassing public comment by missing key statutory deadlines, we have become increasingly concerned with the Administration's lack of transparency as it implements a law that will affect more than 300 million lives and one-sixth of the American economy."


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