Medicaid

Prescription Drug Coverage

Policy 9925

11/01/1999 Introduced
03/01/2004 Reapproved
12/01/2008 Revised
10/01/2012 Revised

04/12/2021 Revised

AMCP supports the inclusion of prescription drug coverage in all health care benefit programs, including those administered by the government (e.g. Medicare, Medicaid, health insurance exchanges). Access to a comprehensive prescription drug benefit coupled with proper use of those medications, has been shown to reduce severity and complications in many common illnesses. Failure to provide prescription drug coverage means fewer patients will have effective drug programs available, thereby diminishing their access to medication therapy and increasing the chance that they will require more intensive, costly health care services such as surgery and/or hospitalization. AMCP also supports granting flexibility for managed care organizations to develop clinically sound, evidence-based benefits free from arduous mandates.

(See AMCP Where We Stand Position Statement – Prescription Drug Coverage)

Government-Mandated Pharmacy Benefits

Policy 0101

03/01/2001 Introduced
06/01/2006 Revised

02/13/2019 Reapproved

AMCP supports the right of managed care organizations and their clients to independently make decisions with regard to health benefits that meet the medical needs of specific patient populations while being compassionate, medically sound, timely, and fiscally responsible. Federal and state legislation and regulations should not hinder a health care delivery system's ability to provide customized benefits that assure value and quality patient care for specific patient populations, yet remain affordable.

 
(See AMCP Where We Stand Position Statement – Government-Mandated Pharmacy Benefits)

Patient Satisfaction

Policy 0116

11/01/2001 Introduced
02/01/2006 Revised
12/01/2010 Revised

04/07/2015 Reapproved

AMCP supports the development of mechanisms that measure the level of satisfaction patients have with pharmacy services. Acquired data may be used for quality improvement efforts, to increase public recognition of pharmacy services, monitor trends, benchmark improvement efforts, and establish the value of the array of pharmacy services to all stakeholders.

Best Price Requirements of the Medicaid Drug Rebate Program

Policy 0904

06/01/2009 Introduced

AMCP believes that the best price provisions of the Medicaid prescription drug rebate program, established by the Omnibus Budget Reconciliation Act of 1990 (P.L. 101-508), represents interference by the government into the competitive marketplace that has raised costs unnecessarily by preventing the commercial market from allowing true market dynamics to emerge. This pernicious market effect has been well documented by the U.S. Government Accountability Office (GAO), the Congressional Budget Office (CBO) and academic economists.  AMCP strongly encourages a careful re-examination of the best price program.

(See AMCP Where We Stand Position Statement – Best Price Requirements of the Medicaid Drug Rebate Program)

Government Regulation of Prescription Drug Prices

Policy 1003

06/01/2010 Introduced

04/12/2021 Revised

AMCP believes that government regulation of prescription drug pricing could result in unintended consequences such as higher costs for patients, payers, and providers. Government-regulated prices could greatly impair the ability of managed care organizations (MCOs) to design a competitive benefit offering that integrates clinically sound, evidence-based medication choices with delivery systems and co-payment alternatives that provide beneficiaries with substantive choice. AMCP works to ensure patient access to medications at an affordable cost and supports working with elected officials and health care stakeholders to develop practical, informed, and market-based solutions to make prescription drugs more affordable and accessible.

(See AMCP Where We Stand Position Statement – Government Regulation of Prescription Drug Prices)