Leavitt Partners evaluated the operational feasibility, potential benefits, and likely drawbacks of novel federal policy approaches which would establish a separate federal payment mechanism for cell and gene therapies (CGTs) delivered to Medicaid beneficiaries. The report, informed by Medicaid program experts, found several theoretical benefits to a federal program that could help to ease state budgetary pressures, but ultimately concluded that such an approach also has the potential to generate federal costs, create similar concerns from beneficiaries and their families regarding a lack of consistent, timely access to care and treatments, and add a layer of complexity with limited benefits in a challenging political environment. The report includes recommendations on incremental federal actions that would help to ease state challenges by facilitating the creation of value-based arrangements and improving data sharing to address key challenges presented by CGTs.