Statement of ACAP on Proposed Rule Modifying Discount Safe Harbor

FOR IMMEDIATE RELEASE: April 8, 2019
FOR MORE INFORMATION: Jeff Van Ness, (202) 204-7515, jvanness@communityplans.net

WASHINGTON—Jennifer McGuigan Babcock, Vice President of Medicaid Policy of the Association for Community Affiliated Plans (ACAP), offered a statement today on the proposed rule modifying the discount safe harbor provision of the federal Anti-Kickback Statute.

In its comments, ACAP has requested that the HHS Secretary exclude Medicaid from the scope of the rule and delay implementation of the rule until further study of its effects can be conducted:

“Keeping Medicaid drug pricing practices within a safe harbor avoids harmful cuts in services to Medicaid beneficiaries and saves taxpayers money.

“These savings are considerable. A study ACAP commissioned in November 2018 by The Menges Group found that managed care organizations deliver more savings to patients than fee-for-service-models. The average post-rebate cost of a Medicaid prescription in 2017 was 26 percent lower from a managed care organization than from a fee-for-service provider. Medicaid managed care organizations’ rebates on brand-name prescriptions saved taxpayers nearly $19 billion in 2017 alone.

“As managed care organizations continue to handle a large and growing share of prescription drug expenses, it will become even more necessary to maintain the flexibility safe harbor offers such that managed care plans can continue to deliver value for taxpayers and contain the growing costs of prescription drugs.”

To read ACAP’s comments in full, visit communityplans.net.

About ACAP:
ACAP represents 65 health plans which collectively provide health coverage to more than 20 million people in 29 states. Safety Net Health Plans serve their members through Medicaid, Medicare, the Children’s Health Insurance Program (CHIP), the Marketplace and other publicly-sponsored health programs. For more information, visit www.communityplans.net.