Earlier this month, the Centers for Medicare & Medicaid Services (CMS) announced a new drug payment initiative aimed at addressing high and rising prescription drug spending in Medicaid. The GENEROUS (GENErating cost Reductions fOr U.S. Medicaid) Model, set to launch in 2026, allows CMS to negotiate with participating manufacturers for lower drug prices, while states that join the program implement standardized and transparent coverage criteria.
Building on the Medicaid Drug Rebate Program and the Cell and Gene Therapy Access Model, GENEROUS requires accepted manufacturers to enter agreements with CMS establishing set drug pricing based on international data, with states invoicing manufacturers for supplemental rebates to achieve those prices and CMS overseeing payment accuracy. The model aims to improve patient access, enhance coverage, and reduce federal and state Medicaid expenditures. Learn more.
Last Updated on November 25, 2025 by Aimed Alliance
