The initiative involves manufacturers providing drugs at international prices, with rebates and federal savings shared, and runs through 2030 to curb rising drug costs for Medicaid recipients

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CMS Announces Participants in Landmark Medicaid Drug Payment Model to Bring Down Drug Costs

CMS Announces Participants in Landmark Medicaid Drug Payment Model to Bring Down Drug Costs

On Friday, September 18, the Centers for Medicare & Medicaid Services (CMS) announced it is working to end skyrocketing drug costs. The agency announced that all 50 states, plus the District of Columbia and Puerto Rico, have applied to participate in an initiative that provides most-favored-nation pricing for certain prescription drugs to people with Medicaid. 

A CMS news release said that forty states and Puerto Rico have already signed agreements to participate in the program, which will lower Medicaid drug costs to the levels paid by other countries. CMS estimates the program will save $64.3 billion in taxpayer dollars over the next ten years.

Under the GENEROUS (GENErating cost Reductions fOr U.S. Medicaid) Model: 

  • Participating manufacturers will make covered outpatient drugs available to participating state Medicaid programs at most-favored-nation pricing.
  • Under agreements with states, participating manufacturers will be invoiced by states for supplemental rebates to align with international prices. CMS will monitor pricing accuracy and share in rebates with states by reducing its federal share of Medicaid payments.

Remaining states have until Sept. 30, 2026, to sign agreements with CMS to participate in the model. The GENEROUS Model launched in January 2026 and runs for five years.

About the Author

Pietje Kobus-McAllister

Pietje Kobus-McAllister

Lead Reporter

Pietje Kobus-McAllister has an international background and experience in content management and editing. She studied journalism in the Netherlands and Communications and Creative Nonfiction in the U.S. Pietje joined Healthcare Innovation in January 2024.

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