BUDGET
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THE <strong>BUDGET</strong> FOR FISCAL YEAR 2017 137<br />
Table S–9. Mandatory and Receipt Proposals—Continued<br />
(Deficit increases (+) or decreases (–) in millions of dollars)<br />
Totals<br />
2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026<br />
2017–2021 2017–2026<br />
Correct Affordable Care Act (ACA)<br />
Medicaid rebate formula for new<br />
drug formulations and exempt abuse<br />
deterrent formulations ....................... ......... –410 –410 –415 –425 –425 –435 –440 –440 –440 –445 –2,085 –4,285<br />
Exclude authorized generics from<br />
Medicaid brand-name rebate<br />
calculations ...................................... ......... –20 –20 –20 –20 –20 –20 –20 –20 –20 –20 –100 –200<br />
Exclude brand-name and authorized<br />
generic drug prices from Medicaid<br />
Federal upper limit (FUL) .............. ......... –30 –60 –90 –90 –100 –100 –100 –100 –100 –100 –370 –870<br />
Clarify the Medicaid definition of<br />
brand drugs to prevent inappropriately<br />
low rebates ............................. ......... –21 –21 –21 –26 –26 –26 –26 –31 –31 –31 –115 –260<br />
Additional improvements to the Medicaid<br />
drug rebate program .............. ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... .........<br />
Total, Medicaid and Children’s Health<br />
Insurance Program ........................... ......... 9,005 6,265 6,489 2,139 2,434 2,023 892 1,364 1,360 –4,337 26,332 27,634<br />
Other health:<br />
Medicare-Medicaid enrollees:<br />
Ensure retroactive Part D coverage of<br />
newly-eligible low-income beneficiaries<br />
............................................... ......... ......... ......... ......... 10 10 10 10 20 20 20 20 100<br />
Establish integrated appeals process<br />
for Medicare-Medicaid enrollees .... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... .........<br />
Allow for Federal/State coordinated<br />
review of Duals Special Need Plan<br />
marketing materials ....................... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... .........<br />
Align Medicare Savings Program<br />
income and asset definitions with<br />
Part D low-income subsidy definitions<br />
................................................. ......... 31 32 34 35 38 40 42 45 48 51 170 396<br />
Total, Medicare-Medicaid enrollees ......... 31 32 34 45 48 50 52 65 68 71 190 496<br />
Pharmaceutical savings:<br />
Prohibit brand and generic drug<br />
companies from delaying the availability<br />
of new generic drugs and<br />
biologics ........................................... ......... –920 –1,010 –1,100 –1,210 –1,290 –1,400 –1,500 –1,610 –1,730 –1,860 –5,530 –13,630<br />
Modify length of exclusivity to facilitate<br />
faster development of generic<br />
biologics ........................................... ......... ......... ......... –230 –590 –780 –870 –1,020 –1,080 –1,140 –1,250 –1,600 –6,960<br />
Establish transparency and reporting<br />
requirements in pharmaceutical<br />
drug pricing ..................................... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... ......... .........<br />
Total, pharmaceutical savings ........ ......... –920 –1,010 –1,330 –1,800 –2,070 –2,270 –2,520 –2,690 –2,870 –3,110 –7,130 –20,590<br />
Public health and workforce<br />
investments:<br />
Support Teaching Health Centers<br />
Graduate Medical Education<br />
(GME) .............................................. ......... ......... 74 214 141 99 ......... ......... ......... ......... ......... 528 528<br />
Support Children’s Hospital GME ..... ......... 130 269 286 292 295 165 27 9 2 ......... 1,272 1,475
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