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GAO-16-412R 1 (2016-02-16)

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G      A     O       U.S. GOVERNMENT ACCOUNTABILITY OFFICE
441 G St. N.W.
Washington, DC 20548


B-327762


February 16, 2016

The Honorable Orrin G. Hatch
Chairman
The Honorable Ron Wyden
Ranking Member
Committee on Finance
United States Senate

The Honorable Fred Upton
Chairman
The Honorable Frank Pallone, Jr.
Ranking Member
Committee on Energy and Commerce
House of Representatives

The Honorable Kevin Brady
Chairman
The Honorable Sander M. Levin
Ranking Member
Committee on Ways and Means
House of Representatives

Subject: Department of Health and Human Services, Centers for Medicare & Medicaid Services:
       Medicaid Program; Covered Outpatient Drugs

Pursuant to section 801 (a)(2)(A) of title 5, United States Code, this is our report on a major rule
promulgated by the Department of Health and Human Services, Centers for Medicare &
Medicaid Services (CMS) entitled Medicaid Program; Covered Outpatient Drugs (RIN: 0938-
AQ41). We received the rule on January 27, 2016. It was published in the Federal Register as
a final rule with comment period February 1, 2016. 81 Fed. Reg. 5170.

The final rule implements provisions of the Patient Protection and Affordable Care Act of 2010,
as amended by the Health Care and Education Reconciliation Act of 2010, pertaining to
Medicaid reimbursement for covered outpatient drugs (CODs). This final rule also revises other
requirements related to CODs, including key aspects of their Medicaid coverage and payment
and the Medicaid drug rebate program.

Enclosed is our assessment of CMS's compliance with the procedural steps required by section
801 (a)(1)(B)(i) through (iv) of title 5 with respect to the rule. Our review of the procedural steps
taken indicates that CMS complied with the applicable requirements.


GAO-16-412R

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