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Seema Verma gives update on CMS plans to reduce drug prices

Medicaid waivers will not include lifetime limits, the administrator says.

Susan Morse, Senior Editor

One-on-One with Seema Verma, Administrator of the U.S. Centers for Medicare and Medicaid Services via Washington Post Live on YoutubeOne-on-One with Seema Verma, Administrator of the U.S. Centers for Medicare and Medicaid Services via Washington Post Live on Youtube

Centers for Medicare and Medicaid Services Administrator Seema Verma today unveiled the agency's enhanced drug pricing dashboards, a key piece in efforts to control the cost of medications.

The Medicare and Medicaid drug price dashboards for the first time include year-over-year comparisons on drug pricing.

Past policies capping drug manufacturer penalties have encouraged higher list prices for drugs, Verma said during a forum on America's Health Future by The Washington Post, reiterating statements by Health and Human Services Secretary Alex Azar.

Some of the most commonly used drugs across Medicare Part B and D and Medicaid, in fact, saw double-digit annual increases over the past few years, she said. In 2012, Medicare spent 17 percent of its total budget, or $109 billion, on prescription drugs. In 2016, drug spending increased to 23 percent of the Medicare budget, or $174 billion.

CMS is also updating the Part D Prescriber Public Use File with information on the more than one million healthcare providers who prescribed drugs under Part D.

Verma told Paige Winfield Cunningham of The Washington Post that in 1985 states were spending about 10 percent of their budget on  Medicaid. It's now about a third of their budget.

Medicaid is the number one or number two budget item in most states, crowding out education, infrastructure and other needs.

States have been increasing their spending, leading to more federal oversight, she said.

"One of the biggest barriers to creating innovative programs was CMS," Verma said of her time working with states such as Indiana on Medicaid reform.

CMS wants to give states more flexibility. Work requirements for able-bodied adults to receive Medicaid benefits have been approved in four states.

The Affordable Care Act added able-bodied individuals to the program through Medicaid expansion, she said.

"We don't want to just give these people a card for health insurance," she said.

For these individuals the goal should be to help them to a pathway out of poverty, she said.

Exemptions are in place for the medically frail, or for those with substance abuse disorder, or living in areas where no jobs are available.

Arkansas is working on a partnership with nursing homes for aides and certified nurse assistants, Verma said.

CMS wants to make sure that the Medicaid program is sustainable over the long term, she said.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com

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