Sec. 307. Modification of maximum rebate amount under Medicaid drug rebate program
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Subparagraph
(D)of section 1927(c)(2) of the Social Security Act ( 42 U.S.C. 1396r–8(c)(2) ) is amended to read as follows: Except as provided in clause (ii), in no case shall the sum of the amounts applied under paragraph (1)(A)(ii) and this paragraph with respect to each dosage form and strength of a single source drug or an innovator multiple source drug for a rebate period exceed— for rebate periods beginning after December 31, 2009, and before September 30, 2025, 100 percent of the average manufacturer price of the drug; and for rebate periods beginning on or after October 1, 2025, 125 percent of the average manufacturer price of the drug. If the average manufacturer price with respect to each dosage form and strength of a single source drug or an innovator multiple source drug increases on or after October 1, 2024, and such increased average manufacturer price exceeds the inflation-adjusted average manufacturer price determined with respect to such drug under subclause
(II)for the rebate period, clause
(i)shall not apply and there shall be no limitation on the sum of the amounts applied under paragraph (1)(A)(ii) and this paragraph for the rebate period with respect to each dosage form and strength of the single source drug or innovator multiple source drug. In this clause, the term inflation-adjusted average manufacturer price means, with respect to a single source drug or an innovator multiple source drug and a rebate period, the average manufacturer price for each dosage form and strength of the drug for the calendar quarter beginning July 1, 1990 (without regard to whether or not the drug has been sold or transferred to an entity, including a division or subsidiary of the manufacturer, after the first day of such quarter), increased by the percentage by which the consumer price index for all urban consumers (United States city average) for the month before the month in which the rebate period begins exceeds such index for September 1990. . Section 1927(c)(2)(B) of the Social Security Act ( 42 U.S.C. 1396r–8(c)(2)(B) ) is amended by inserting and clause (ii)(II) of subparagraph
(D)after clause (ii)(II) of subparagraph
(A). Section 1927(c)(3)(C)(ii)(IV) of the Social Security Act ( 42 U.S.C. 1396r–9(c)(3)(C)(ii)(IV) ) is amended— by striking subparagraph
(A)and inserting paragraph (3)(A) ; and by striking this subparagraph and inserting paragraph (3)(C) .
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3 references not yet in our index
- 42 USC 1396r–8(c)(2)
- 42 USC 1396r–8(c)(2)(B)
- 42 USC 1396r–9(c)(3)(C)(ii)(IV)
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cites case law
Sec. 307
Modification of maximum rebate amount under Medicaid drug rebate program
Cite42 USC 1396r–8(c)(2)
Cite42 USC 1396r–8(c)(2)(B)
Cite42 USC 1396r–9(c)(3)(C)(ii)(IV)
Cites 3Cited by 0 across 0 sources