January 10, 2020

Texas HHS seeks approval to enter into value-based agreements with drug manufacturers based on outcome data or other metrics. The agreement must be consistent with federal law and approved by the Centers for Medicare and Medicaid Services (CMS) as part of the Medicaid state plan. Agreements may include things of value, including, but not limited to:

  • Rebate
  • Discount
  • Price reduction
  • Contribution
  • Risk sharing
  • Reimbursement
  • Payment deferral or installment payments
  • Guarantee
  • Patient care
  • Shared savings payments
  • Withholds
  • Bonuses

Drug manufacturers interested in participating in this rebate program should complete and submit the Value-Based Agreement Concept (HHS Form 1402). Texas HHS will review and consider all proposals submitted by a drug manufacturer, but not execute agreements until CMS approval.