The Times They Are a-Changin – A Look at Congressional Efforts to Reform the Medicare and Medicaid Prescription Drug Programs

ACPE UAN #:  0233-0000-19-054-H04-P

Release DateOctober 30, 2019

Expiration Date:  October 30, 2022

Activity Type:    Knowledge-based

Contact Hours:  1.5 

Activity Fee:  Member:  FREE       Non-Member: $30

Target Audience: Pharmacists who practice in managed care settings.

Activity Description:

For more than a decade, millions of American seniors have been able to access prescription drugs through market-driven programs that allow private Medicare Part D and Medicare Advantage (MA) plans to compete using a standardized plan design. Furthermore, for nearly 30 years, millions more Americans have accessed medications through the Medicaid Drug Rebate Program, under which payer and manufacturer obligations have remained relatively intact.  Despite the successes of these programs, many in the Administration and Congress have prioritized reform in order to address rising drug costs. Just this last summer, we saw a (now-abandoned) effort by the Administration to effectively prohibit manufacturer rebates in Medicare Part D and Medicaid managed care, a proposal that would have upended the current system by which plans (and their contracted PBMs) negotiate discounts with pharmaceutical manufacturers. Now, Congress is debating and considering multiple proposals that would change many of the keystone features of these programs.  This session will provide an in-depth look at the possibilities for legislative change for Medicare and Medicaid drug coverage and payment. We will examine the major proposals from both the House and Senate, consider their differences and prospects, and forecast what a revamped prescription drug program in Medicare and Medicaid could look like for payers, providers, PBMs, and patients. 

Learning Objectives:

At the completion of this activity, participants should be able to: 

  1. Summarize the major proposals currently being debated in Congress to reform or revamp the Medicare and Medicaid prescription drug programs.
  2. Discuss the expected impact of these proposals on future negotiations between manufacturers, payers, and PBMs.
  3. Describe the political dynamics and prospects for the various pieces of legislation. 

Schedule of Educational Activity:

This activity consists of an audio recording, pre-test assessment questions (not required to pass to continue), post-test questions (required to pass with a score of 70% or higher) and a specific activity evaluation. 

Accreditation Statement:

The Academy of Managed Care Pharmacy (AMCP) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

As an accredited provider, AMCP strictly adheres to the ACPE Standards for Commercial Support and other relevant guidelines and standards to ensure the independence of continuing pharmacy education (CPE) activities.  AMCP intends that all CPE activities be independent, objective, balanced, evidence-based, and free of any commercial bias.

CPE Requirements:   

Participants should claim continuing pharmacy education (CPE) credit for this home study activity only if they have not claimed credit for the live activity presented at AMCP Nexus 2019.

CPE credit will be processed through the AMCP Learn portal and reported directly to CPE Monitor.  Please allow 72 hours for processing and posting in your NABP account.

To receive credit for an online activity you must:

  • Review the full content of the activity.
  • Successfully complete the post-test (required to pass with a score of 70% or higher, it may be taken a maximum of three times).
  • Complete a specific activity evaluation.


David Wamble | PhD | Director, Health Economics | RTI Health Solutions |  Research Triangle Park, North Carolina.

System Technical Requirements/Viewing Requirements: System Requirements Courses and learning activities are delivered via your Web browser and Acrobat PDF. For all activities, you should have a basic comfort level using a computer and navigating websites.  View the minimum technical and system requirements for continuing education online learning activities.

Credit Information

Activity Number Credit Amount Accreditation Period
ACPE UAN #0233-0000-19-054-H04-P 1.5 Contact Hours October 30, 2019 - October 30, 2022