Projects

Medicaid Drug Programs (MDP)

2021- 2025
Health Medicaid and CHIP Data Analytics Data Management Data Visualization Surveys and Data Collection

Project Overview

Objective

Mathematica supports product management for the system the Centers for Medicare & Medicaid Services (CMS) uses to administer the Medicaid Drug Rebate Program (MDRP) as well as the Medicaid Drug Utilization Review (DUR) survey and reporting process.

Project Motivation

The MDRP offsets Federal and state costs of outpatient prescription drugs dispensed to the Medicaid population. The Medicaid Drug Programs system (MDP) calculates rebate amounts that drug manufacturers and labelers owe to state Medicaid agencies that cover their outpatient prescription drugs. Under the Medicaid DUR Program, state Medicaid agencies implement programming to reduce abuse and misuse of Medicaid-covered outpatient prescription drugs. The DUR module of MDP allows CMS to collect information about DUR policies and programs state Medicaid agencies have in place, on an annual basis. CMS shares the information collected with various stakeholders, so they can understand trends and recommend policy interventions.

Partners in Progress

  • Softrams
  • Skilalogy

Prepared For

U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Data and Systems Group (DSG), Division of Information Systems (DIS)

Mathematica partners with Softrams to develop and enhance the Medicaid Drug Programs (MDP) product suite. Mathematica provides subject matter expertise and supports stakeholder engagment.
Mathematica works with CMS end users of MDP to gather and document functional requirements for system features. These requirements serve as inputs that Softrams MDP leadership and engineers use to formulate approaches to meeting customer needs. Once our customer agrees on acceptance criteria for features, Mathematica staff support the engineers as they implement features by clearly communicating criteria; approving test plans to ensure the features are implemented as expected; and accepting features as complete. On MDP, Mathematica follows SAFe Agile practices, which promote iterative development and continuous improvement.

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