Latebreakers: States undecided on AMP

May 21, 2007

A report from the HHS Office of the Inspector General (OIG) has found that most states have not decided whether to use average manufacturer price (AMP) data for Medicaid drug reimbursement due to concerns over the availability and quality of AMP data.

A report from the HHS Office of the Inspector General (OIG) has found that most states have not decided whether to use average manufacturer price (AMP) data for Medicaid drug reimbursement due to concerns over the availability and quality of AMP data. The Deficit Reduction Act mandated that CMS use AMP to determine its pharmacy reimbursement in 2007 but does not require the states to use the data. CMS began sending states AMP data monthly in 2006 and is slated to provide retail sales price (RSP) data this year as well. Of the 47 states that completed the OIG survey, 39 have taken no steps regarding use of AMP data, four are planning to use AMP data for Medicaid drug reimbursement but have not yet implemented changes, three states do not plan on using AMP data at all, and one state will use AMP data to determine its maximum allowable costs (MACs). The report did not identify the states that completed the survey or the policies of individual states.