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AMCP Regulatory NewsBreaks

Regulatory NewsBREAK: CMS Releases the Maximum Fair Price (MFP) for Selected Drugs for IPAY 2027

On November 25, 2025, the Centers for Medicare & Medicaid Services (CMS) released the maximum fair price (MFP) for each of the 15 selected drugs for IPAY 2027, which will go into effect beginning January 1, 2027. These negotiated prices reflect a marked increase in savings compared to the initial 2026 cohort, influenced by newer drugs and expanded pricing benchmarks.
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AMCP Regulatory NewsBreaks

Regulatory NewsBREAK: CMS Releases the GENEROUS Model (Generating Cost Reductions for U.S. Medicaid Model)

On November 6, 2025, the Centers for Medicare & Medicaid Services (CMS) released the GENEROUS Model (Generating Cost Reductions for U.S. Medicaid Model). The model aims to achieve Most Favored Nation (MFN) international pricing for Covered Outpatient Drugs (CODs) while maintaining or improving the quality of care for Medicaid beneficiaries.
Legislation & Regulation
AMCP Regulatory NewsBreaks

Regulatory NewsBREAK: CMS Issues Final Guidance on Medicare Drug Price Negotiation Program

On September 30, 2025, the Centers for Medicare and Medicaid Services (CMS) issued final guidance for the third cycle of the Medicare Drug Price Negotiation Program for Initial Price Applicability Year (IPAY) 2028. Negotiations for the Maximum Fair Prices (MFP) on up to 15 additional negotiation-eligible Part D and/or Part B drugs will occur in 2026, with the MFP effective in IPAY 2028.
Legislation & Regulation
Pills

White House Announces Deal to Lower Drug Costs

On September 30, 2025, the White House announced a deal with Pfizer to lower drug costs in line with most-favored nation (MFN) pricing. While specific terms of the agreement have not been disclosed, both Pfizer and the White House issued statements providing a broad outline of the agreement.
Legislation & Regulation
AMCP Regulatory NewsBreaks

HSS Issues Updates to the Final Rule on HIPAA, NCPDP Standards, and the Medicaid Pharmacy Subrogation Standard

On August 20, 2025, the U.S. Department of Health and Human Services (HHS) issued updates (the Interim Final Rule) which amends the final rule titled “Administrative Simplification: Modifications of Health Insurance Portability and Accountability Act of 1996 (HIPAA) National Council for Prescription Drug Programs (NCPDP) Retail Pharmacy Standards; and Modification of the Medicaid Pharmacy Subrogation Standard,” (the December 2024 Final Rule).
Legislation & Regulation