MACPAC approves recommendations on specialty drugs, behavioral health


The Medicaid and CHIP Payment and Access Commission approved recommendations on accelerated-approval drugs and behavioral health services during its April meeting on Friday.

Commissioners voted to recommend that Congress increase the minimum rebate percentage and additional inflationary rebate on drugs approved by the Food and Drug Administration through the accelerated approval program. MACPAC commissioner Thomas Barker was the only commissioner to vote against the measure.

According to MACPAC, the changes would lower Medicaid spending on high-cost specialty drugs. Drugmakers and some patient advocates claim those moves could discourage pharmaceutical companies from bringing new products to market. But many experts disagree, arguing that historical evidence shows those claims are mostly unsupported and that drugmakers’ financial incentives would remain largely the same.

MACPAC also approved recommendations on behavioral health for adults, children and adolescents.

The commission wants CMS and the Substance Abuse and Mental Health Services Administration to put out joint guidance about how Medicaid and the State Children’s Health Insurance Program can fund a crisis continuum for adult beneficiaries experiencing behavioral health crises. It also wants CMS, SAMHSA and the Administration for Children and Families to create shared guidance addressing the design and implementation of benefits for children and adolescents with significant mental health conditions covered by Medicaid and CHIP.

In addition, CMS and SAMHSA should provide education and technical assistance to help states put a behavioral health care continuum for adults into practice, according to MACPAC. HHS should also examine options to use existing federal funding to support state-level activities to improve crisis service availability, the commission said.

MACPAC approved similar recommendations to improve access to home and community-based behavioral health services for children and adolescents.



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