GENEROUS Medicaid drug pricing deal hits Sept 30 state deadline

American Health Intel

Rules · Money · Medicine · Decoded daily

GENEROUS Medicaid drug pricing deal hits Sept 30 state deadline

Plus: CMS cancels ACA marketplace coverage for 760K people. The day's rules, money, and enforcement, sourced and tiered below.

Record

A Trump administration program called GENEROUS aims to make drug companies sell certain medicines to state Medicaid programs at close to what other wealthy countries pay, saving the federal government billions.

CMS says GENEROUS could save $64.3 billion over 10 years. 40 states and Puerto Rico have signed on. The rest have until Wednesday, September 30, to sign or skip the program entirely.

Record

CMS, the federal agency that runs Medicare and Medicaid, canceled health insurance for more than 760,000 people it says were improperly enrolled in ACA marketplace plans, and expects to recover billions in subsidies.

About 315,000 enrollments were canceled, expected to recover $2.2 billion in taxpayer subsidies. CMS also froze new insurance broker signups for 2027 and has already terminated over 200 brokers since January.

Also today

24 state AGs oppose CMS Medicaid provider-tax rule Read
OIG: New York owes $6.2M for Medicaid payments on incarcerated enrollees Read
Medicare's 2027 doctor pay rule missing from OIRA with Nov 1 deadline looming Read
Doctors and patients sue CMS over Medicaid work-requirement frailty exemption Read

Pick your field on the site and every story tells you what it means for you.

Reply to this email and tell us what you want covered. We read everything.

We show our work. We score our own calls.

Track record · Calendar · Enforcement · X · LinkedIn

News and analysis, not legal, medical, coding, or investment advice.
You subscribed at americanhealthintel.com · Unsubscribe