Episode 87 – Drug Pricing: What’s In the New CMS Medicaid Final Rule?

Connected With Latham

The Centers for Medicare & Medicaid Services (CMS) recently published its final rule to implement the Medicaid Services Investment and Accountability Act of 2019 (MSIAA). The final rule significantly deviates from the agency’s 2023 proposal, with CMS backing off from “follow the pill” best price stacking, subjecting certain vaccines to Medicaid rebates, and creating a “shame list” of high-cost Medicaid drugs, among other proposals. But the final rule still imposes new burdens on manufacturers, such as by expanding which type of utilization triggers a Medicaid rebate, and imposing aggressive compliance deadlines in connection with misclassifications. In this episode of Connected With Latham, Washington, D.C. partner Chris Schott and associate Danny Machado break down what CMS included — and omitted — from its final rule. They also speculate about the impact the Supreme Court’s overturning of the Chevron doctrine might have had on CMS’ regulatory decision-making, as well as why the final rule’s effective date is 60 days before the next presidential inauguration.

This podcast is provided as a service of Latham & Watkins LLP. Listening to this podcast does not create an attorney client relationship between you and Latham & Watkins LLP, and you should not send confidential information to Latham & Watkins LLP. While we make every effort to assure that the content of this podcast is accurate, comprehensive, and current, we do not warrant or guarantee any of those things and you may not rely on this podcast as a substitute for legal research and/or consulting a qualified attorney. Listening to this podcast is not a substitute for engaging a lawyer to advise on your individual needs. Should you require legal advice on the issues covered in this podcast, please consult a qualified attorney. Under New York’s Code of Professional Responsibility, portions of this communication contain attorney advertising. Prior results do not guarantee a similar outcome. Results depend upon a variety of factors unique to each representation. Please direct all inquiries regarding the conduct of Latham and Watkins attorneys under New York’s Disciplinary Rules to Latham & Watkins LLP, 1271 Avenue of the Americas, New York, NY 10020, Phone: [phone]