Sen. Johnson and Finance Committee Republicans: New Medicaid Rule Risks Disrupting Patient Care

WASHINGTON – On Friday, U.S. Sen. Ron Johnson (R-Wis.) joined Ranking Member Mike Crapo (R-Idaho.) and nine other Senate Finance Committee Republicans in sending a letter regarding the Centers for Medicare & Medicaid Services (CMS) proposed rule to change Medicaid Drug Rebate Program (MDRP) operations in ways that offer no material benefit for patients. In the letter to Administrator Chiquita Brooks-LaSure, the senators urged the Administration to withdraw problematic components of the proposed rule and to work with Congress to develop improvements to the Medicaid program so patients have access to cutting-edge, life-saving prescription drugs. 

The senators note, “While we share some of the agency’s objectives, including preventing certain problematic practices within the prescription drug supply chain, many of the [rule’s] proposed changes defy longstanding statutory understanding and impose costly new mandates, creating fiscal uncertainty for states and risking patient access to the most innovative therapies and cures.”

They identify several problems with the proposal, including “stacking” to compute the “Best Price” benchmark, which would create technical complications and risk undercutting the policy’s core objectives by disincetivizing larger price concessions.  

The senators also highlight the lack of a patient-oriented justification for the proposal’s price verification survey, noting that the proposed rule seeks to establish a survey process for certain “high cost” covered outpatient drugs, like cell and gene therapies, instead of addressing the access barriers identified by states, patients, and providers.

They end the letter, “We urge CMS to preserve the MDRP’s statutory balance consistent with Congress’s intent by withdrawing the misguided proposals that risk disrupting patient care.  We would welcome the opportunity to work with you to improve the Medicaid program so that patients have access to cutting-edge, live-changing prescription drugs.”

Sens. Johnson and Crapo were joined on the letter by Senators John Cornyn (R-Texas), John Thune (R-S.D.), Tim Scott (R-S.C.), James Lankford (R-Okla.), Steve Daines (R-Mont.), Todd Young (R-Ind.), John Barrasso, M.D. (R-Wyo.), Thom Tillis (R-N.C.), and Marsha Blackburn (R-Tenn.). 

Full text of the letter can be found here.