Medicaid Managed Care

The Academy of Managed Care Pharmacy (AMCP) thanks the Centers for Medicare & Medicaid Services (CMS) for the opportunity to provide comments in response to the “Medicare and Medicaid Programs; CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program” (Proposed Rule), issued on July 16, 2025.

In both of his administrations, President Trump promoted most-favored nation (MFN) pricing as a way to bring down drug costs in the United States. On July 31, 2025, President Trump sent letters to 17 pharmaceutical manufacturers demanding that they implement MFN prices or face the consequences.

Value-based payments (VBP) systems incentivize providers to improve patient outcomes, reduce costs, and improve the overall patient experience, making them a critical tool for promoting high-quality, affordable care. However, defining and measuring the value of a drug can be complex, especially when considering factors like clinical outcomes, patient characteristics, and population health. AMCP supports the Medicaid VBPs for Patients (MVP) Act to modernize the framework for value-based purchasing arrangements in Medicaid, ensuring that the proper channels exist to connect Medicaid patients with the therapies they need.

Host Fred Goldstein invites Jennifer Mathieu, Senior Vice President, Professional & Government Affairs to discuss the Prescription Digital Therapeutics Act, the Medicaid MVPs for Patient Act and other AMCP legislative priorities.