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Commentary by Dr. Robert Levin: Pharmacy benefit managers can still game the system despite Senate attempt to close Medicaid loophole

On Dec. 4, Senators Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.) introduced new legislation to ensure that drug companies play by the rules of the Medicaid program. The bill is aimed at preventing drug companies from overcharging Medicaid, a practice that has been consistently costing taxpayers billions of dollars. While the legislation is an excellent indicator of future bipartisan cooperation on the issue of prescription drug affordability, much more needs to be done.

Grassley and Wyden’s new bill, the Right Rebate Act, would give the U.S. Department of Health and Human Services (HHS) the ability to fine companies that knowingly misclassify drugs in the future. It would also give HHS the ability to directly adjust a drug’s classification. The issue stems from drugs being misclassified by manufacturers as generic when they should be classified as brand name.

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Barbara Arnago