Medicaid and Medicare Part D take up a disproportionate share of both state budgets and state legislators’ attention. NLARx is assisting state legislators with the legal, financial, and practical implications of Part D, including “clawback” payments to the federal government, the impact on Medicare/Medicaid “dual eligibles,” and the shift of drug utilization information and purchasing clout from state governments to the private sector. NLARx has advocated for major reforms in the Medicare drug benefit, including instituting price negotiation, providing for at least one government-run plan, reducing the complexity of the program and eliminating the financial penalties. NLARx is also working with states to develop effective strategies to keep Medicaid pharmaceutical costs down without cutting benefits or compromising patient health, and to recover funds from the pharmaceutical industry for fraud and mismanagement.

Researching this Issue

Model state laws and best practices, testimony supporting these initiatives, background information and research materials on Medicaid and Medicare Part D, including reports, legal materials and news articles, are posted here. Information of federal legislation related to Medicaid and Medicare, as well as materials on pharmaceutical fraud litigation and state False Claims Acts, is also posted on this page. Other relevant materials may be found throughout the website, including the issue pages relating to Pricing, which has information on drug costs and AWP pricing and disclosure; and on PBMs, Preferred Drug Lists, Purchasing Pools, and Generics, since all of these subjects figure in state and federal Medicaid and Medicare policy. See also the Related Links below to connect to other organizations with a primary focus on Medicare and Medicaid litigation and access.


Model Legislation
Mar 01, 2006
Model State Resolution to Fix Medicare Part D | >>more
Sep 29, 2005
State False Claims Act | >>more
Jul 19, 2005
Vermont Medicare Wraparound Law | >>more
>> view all Model Legislation
 
Testimony
May 03, 2006
On Medicare Part D Implementation | >>more
 
Related News
May 05, 2008
New York Times
States Look to Rein In Private Medicare Plans | >>more
May 02, 2008
Congressional Quarterly Health Beat
Medicare Bill May Be on Senate's Back Burner Awhile | >>more
May 02, 2008
Kaiser Daily Health Report
Enrollment for Wisconsin's New Consolidated Health Program Higher Than Expected, Could Affect Costs | >>more
>> view all News
 
Reports
May 09, 2008
Spend Money to Save: Funding Part D Appeals to Conserve State Resources | >>more
May 05, 2008
State Medicaid Data: Legal Issues Concerning Use and Disclosure | >>more
Apr 09, 2008
Kaiser Issues New Synthesis of Findings from Analysis of Features and Trends for Medicare Drug Plans | >>more
>> view all Reports
 
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