To be eligible for Medicaid coverage, drug manufacturers must participate in the Medicaid Drug Rebate Program (MDRP) and pay rebates on dispensed medications. Non-participating manufacturers’ drugs are not covered.
Bausch Health (Bausch & Lomb) recently announced their withdrawal from the MDRP, meaning their medications are no longer covered by Medicaid.
What happens when coverage changes?
When medications lose coverage due to rebate status changes, providers typically have two options:
- Switch to an alternative medication that remains covered.
- Submit prior authorization or appeal, if clinically necessary.
Visit the link below to see Bausch Health’s list of impacted medications.