H.R. 5145 · 114th Congress

To amend title XIX of the Social Security Act to exclude abuse-deterrent formulations of prescription drugs from the Medicaid additional rebate requirement for new formulations of prescription drugs, and for other purposes.

Stage
In committee
Introduced
2016-04-29
Latest action
2016-05-17 · Referred to the Subcommittee on Health.

Summary

This bill amends title XIX (Medicaid) of the Social Security Act to exclude abuse-deterrent formulations of prescription drugs from the requirement that manufacturers of single-source or innovator drugs pay additional rebates to state Medicaid programs.

Under current law, the Centers for Medicare & Medicaid Services (CMS) must use predictive modeling and other analytic technologies to identify improper Medicaid claims. The bill prohibits a state agency from using or disclosing such technologies except for purposes of administering a state Medicaid program or Children's Health Insurance Program (CHIP). A state agency shall have in effect adequate data security and control policies to ensure that access to such information is restricted to authorized persons for authorized uses.

The bill places $5 million in the Medicaid Improvement Fund to be available beginning in FY2021.