The Other Medicaid Drug Rebate News: Oklahoma’s State Plan Amendment

On June 27, 2018, the Centers for Medicare & Medicaid Services (CMS) approved a state plan amendment (SPA) authorizing Oklahoma’s Medicaid program to enter into value-based purchasing arrangements with drug manufacturers. The new SPA permits the state to negotiate supplemental drug rebates based on performance and outcome benchmarks as part of a value-based contract, which the state of Oklahoma and drug manufacturers may enter into voluntarily. The new rebate program is in addition to the federal rebate program and the state’s supplemental rebate program, both of which are based on a drug’s utilization versus performance.

Oklahoma’s Medicaid program will implement any value-based contract based on the model agreement entitled “Value-Based Supplemental Rebate Agreement,” proposed to CMS on March 29, 2018 and authorized retroactively for use as of January 1, 2018.