H.R. 4978 would exclude formulations of prescription drugs that include abuse deterrents from Medicaid’s requirement that new drug formulations pay additional rebates. The bill also would prevent the disclosure of algorithms used to detect fraud, provide additional funding to the Medicaid Improvement Fund, and require the Government Accountability Office to submit a report to the Congress on neonatal abstinence syndrome in the United States.
CBO estimates that enacting H.R. 4978 would not, on net, change direct spending over the 2017-2026 period. Some provisions of the bill would increase direct spending by $80 million over that period while other provisions would decrease direct spending by the same amount. In addition, CBO estimates that implementing H.R. 4978 would have a discretionary cost of less than $500,000; any such spending would be subject to the availability of appropriated funds. Pay-as-you-go procedures apply because enacting the legislation would affect direct spending. Enacting the legislation would not affect revenues.
CBO estimates that enacting the legislation would not increase net direct spending or on-budget deficits by more than $5 billion in any of the four consecutive 10-year periods beginning in 2027.
H.R. 4978 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act.
