[19990809]RS20295_门诊处方药：选定联邦计划下的采购和报销政策.pdf

Congressional Research Service The Library of CongressCRS Report for CongressReceived through the CRS WebOrder Code RS20295August 9, 1999Outpatient Prescription Drugs: Acquisition andReimbursement Policies Under Selected FederalProgramsHeidi G. YackerInformation Research SpecialistInformation Research DivisionSummaryVarying reimbursement methods determine the payments for outpatient drugssupplied under different federal programs. The Veterans Health Care Act of 1992 limitsthe prices that drug manufacturers can charge the Department of Veterans Affairs (VA);several other government agencies, including the Department of Defense (DOD), are ableto purchase pharmacy supplies through the VA supply system. The Medicaid programreimburses providers directly for covered pharmaceuticals, establishing upper paymentlimits on approved drugs and receiving rebates from manufacturers. The Medicareprogram provides limited coverage for outpatient drugs. For those drugs it covers,Medicare reimburses providers at the rate of 95% of the average wholesale price. Thisreport discusses the reimbursement methods used to pay for outpatient prescriptiondrugs by the VA, DOD, Medicaid, and Medicare. It will be u