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CMS Approves Wash. Value-based Arrangement

The Centers for Medicare & Medicaid Services (CMS) approved a proposal to allow Washington state to negotiate supplemental rebates involving Medicaid value-based purchasing arrangements with drug manufacturers.

The state plan amendment (SPA) is specifically designed to allow the state to negotiate under a “subscription” model with manufacturers of prescription drugs that treat patients with hepatitis C. Under this model, the state would pay a fixed annual amount to a pharmaceutical manufacturer to purchase an unrestricted supply of hepatitis C drugs.

With CMS’ approval of the SPA, Washington becomes the fourth state cleared to pursue value-based purchasing agreements for supplemental rebates with manufacturers, after Oklahoma, Michigan, and Colorado. Washington is the first state to receive approval for a plan primarily focused on hepatitis C drugs.

Promoting value-based payments is one of the initiatives outlined in the American Patients First Blueprint, which captures the administration’s plan to combat high drug prices

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Rachel Schwartz is a policy associate at America's Essential Hospitals.

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