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
Feb 18, 2009
Testimony before the Vermont Senate Committee on Health and Welfare | >>more
May 03, 2006
On Medicare Part D Implementation | >>more
Related News
Nov 23, 2010
$3.1 Billion Recovered Through the False Claims Act During Fiscal Year 2010: | >>more
Oct 11, 2010
Legal Newsline
Hawaii AG settles AWP suits for $82M | >>more
Oct 08, 2010
Fierce Pharma
J&J Asks Judge to Toss Omnicare Kickbacks Case | >>more
>> view all News
Dec 18, 2009
New Data Spotlights Examine Premiums, Benefit Design and Cost Sharing, and Enhanced Status For 2010 Part D Medicare Drug Plans | >>more
Nov 23, 2009
Part D Plan Availability in 2010 and Key Changes Since 2006 | >>more
Nov 10, 2009
Kaiser Family Fund Releases Medicare Part D 2010 Data Spotlights | >>more
>> view all Reports
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