CY 2023 Clawbacks: Uncertainty Remains
The Centers for Medicare & Medicaid Services (CMS) recently notified states of calendar year (CY) 2023 clawback multipliers, which are used to calculate state payments to the federal government for the Medicare Part D prescription drug program. According to the CMS release, the per-beneficiary monthly clawback charge will increase by 4.90%.
The Federal Medical Assistance Percentage (FMAP) affects the clawback multipliers. Because the end date of the COVID-19-related, temporary 6.2 percentage-point increase in the FMAP is unknown, CMS provided two multipliers for each state for January – September 2023: with and without the FMAP increase. If the temporary FMAP increase runs through March 2023 (based on the current public health emergency [PHE] renewal), FFIS estimates that CY 2023 clawbacks will cost states $15.8 billion, a $2.6 billion (19.3%) increase from CY 2022.