Medicaid Drug Rebate Program
E637326
The Medicaid Drug Rebate Program is a U.S. federal initiative that requires drug manufacturers to provide rebates to state Medicaid programs in exchange for Medicaid coverage of their outpatient prescription drugs, helping control costs for the program.
All labels observed (3)
| Label | Occurrences |
|---|---|
| Medicaid Drug Rebate Program canonical | 1 |
| Medicaid outpatient prescription drugs | 1 |
| Medicaid prescription drug benefit | 1 |
How this entity was disambiguated
This entity first appeared as the object of triple T7031287 — resolving that mention is where its identity was fixed. The disambiguator weighed these candidate entities and picked the highlighted one (or “None”, minting a new entity). This is how homonymy is resolved: the same surface form can point to different entities.
NED1
Entity disambiguation (via context triple)
gpt-5-mini-2025-08-07
Target entity: Medicaid Drug Rebate Program Context triple: [340B Drug Pricing Program, relatedProgram, Medicaid Drug Rebate Program]
-
A.
340B Drug Pricing Program
The 340B Drug Pricing Program is a U.S. federal initiative that requires drug manufacturers to provide outpatient medications to eligible healthcare organizations at significantly reduced prices to support care for underserved patients.
-
B.
Medicare Prescription Drug, Improvement, and Modernization Act of 2003
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 is a major U.S. federal law that overhauled Medicare by adding outpatient prescription drug coverage and expanding private plan options for beneficiaries.
-
C.
Prescription Drug User Fee Act of 1992
The Prescription Drug User Fee Act of 1992 is a U.S. law that authorizes the FDA to collect fees from pharmaceutical companies to fund and expedite the review of new drug applications.
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D.
Medicare Part D
Medicare Part D is the U.S. federal program that provides outpatient prescription drug coverage to Medicare beneficiaries through private insurance plans.
-
E.
Center for Program Integrity
The Center for Program Integrity is a division within the Centers for Medicare & Medicaid Services responsible for preventing fraud, waste, and abuse in federal health care programs and ensuring proper payment and program compliance.
- F. None of above. chosen
- G. Unsure - the case is ambiguous/there is not enough information to decide.
NED2
Entity disambiguation (via description)
gpt-5-mini-2025-08-07
Target entity: Medicaid Drug Rebate Program Target entity description: The Medicaid Drug Rebate Program is a U.S. federal initiative that requires drug manufacturers to provide rebates to state Medicaid programs in exchange for Medicaid coverage of their outpatient prescription drugs, helping control costs for the program.
-
A.
340B Drug Pricing Program
The 340B Drug Pricing Program is a U.S. federal initiative that requires drug manufacturers to provide outpatient medications to eligible healthcare organizations at significantly reduced prices to support care for underserved patients.
-
B.
Medicare Prescription Drug, Improvement, and Modernization Act of 2003
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 is a major U.S. federal law that overhauled Medicare by adding outpatient prescription drug coverage and expanding private plan options for beneficiaries.
-
C.
Prescription Drug User Fee Act of 1992
The Prescription Drug User Fee Act of 1992 is a U.S. law that authorizes the FDA to collect fees from pharmaceutical companies to fund and expedite the review of new drug applications.
-
D.
Medicare Part D
Medicare Part D is the U.S. federal program that provides outpatient prescription drug coverage to Medicare beneficiaries through private insurance plans.
-
E.
Center for Program Integrity
The Center for Program Integrity is a division within the Centers for Medicare & Medicaid Services responsible for preventing fraud, waste, and abuse in federal health care programs and ensuring proper payment and program compliance.
- F. None of above. chosen
Statements (48)
| Predicate | Object |
|---|---|
| instanceOf |
U.S. federal program
ⓘ
drug rebate program ⓘ |
| administeredBy |
Centers for Medicare & Medicaid Services
ⓘ
U.S. Department of Health and Human Services ⓘ |
| agreementType | national rebate agreement ⓘ |
| appliesTo |
brand-name drugs
ⓘ
generic drugs ⓘ outpatient prescription drugs ⓘ state Medicaid programs ⓘ |
| associatedWithForm |
CMS-64
ⓘ
CMS-R-144 ⓘ |
| benefits |
federal Medicaid program
ⓘ
state Medicaid agencies ⓘ |
| complianceRequirement |
manufacturers must pay quarterly rebates
ⓘ
manufacturers must report pricing data to CMS ⓘ |
| conditionFor | Medicaid coverage of manufacturers’ outpatient drugs ⓘ |
| country |
United States
ⓘ
linked to:
United States of America
|
| covers |
innovator multiple-source drugs
ⓘ
non-innovator multiple-source drugs ⓘ single-source drugs ⓘ |
| dataReportedBy | participating drug manufacturers ⓘ |
| establishedBy | Omnibus Budget Reconciliation Act of 1990 ⓘ |
| excludes | most inpatient hospital drugs ⓘ |
| frequencyOfRebates | quarterly ⓘ |
| fundingFlow | manufacturers pay rebates to states ⓘ |
| fundingFlow | states share rebate information with CMS ⓘ |
| impact | reduces net cost of covered outpatient drugs for Medicaid ⓘ |
| legalBasis | Social Security Act Section 1927 ⓘ |
| monitoredBy |
CMS Medicaid and CHIP Operations Group
ⓘ
linked to:
Centers for Medicare & Medicaid Services
|
| policyTool | pharmaceutical pricing regulation mechanism ⓘ |
| purpose |
to ensure Medicaid receives best price rebates from manufacturers
ⓘ
to reduce Medicaid prescription drug costs ⓘ |
| rebateType |
additional inflation-based rebate
ⓘ
basic rebate ⓘ |
| relatedTo |
340B Drug Pricing Program
ⓘ
Medicaid Drug Utilization Review Program ⓘ Medicaid prescription drug benefit ⓘ
linked to:
Medicaid Drug Rebate Program
Medicare Part D drug coverage ⓘ
linked to:
Medicare Part D
|
| requires |
drug manufacturers to pay rebates to state Medicaid programs
ⓘ
states to submit utilization data to manufacturers ⓘ |
| requiresAgreementWith | drug manufacturers ⓘ |
| scope | outpatient drugs only ⓘ |
| startDate | 1991 ⓘ |
| supports | Medicaid drug cost containment ⓘ |
| targetPopulation | Medicaid beneficiaries using outpatient prescription drugs ⓘ |
| usesDataFrom |
Average Manufacturer Price
ⓘ
Best Price ⓘ National Drug Code ⓘ |
How these facts were elicited
The pipeline generated the facts above by prompting gpt-5.1 with this entity's name + description and the instruction below.
Instruction
You are a knowledge base construction expert. Given a subject entity and a description of it, return factual statements that you know for the subject as a JSON list of dictionaries(triples), where keys must be "subject", "predicate" and "object". The number of facts may be very high, between 25 to 50 or more, for very popular subjects. For less popular subjects, the number of facts can be very low, like 5 or 10. # Requirements - If you don't know the subject at all, return an empty list. - If the subject is not a named entity, return an empty list. - Include at least one triple where predicate is "instanceOf". - Do not get too wordy. - Separate several objects into multiple triples with one object.
Input
Subject: Medicaid Drug Rebate Program Description of subject: The Medicaid Drug Rebate Program is a U.S. federal initiative that requires drug manufacturers to provide rebates to state Medicaid programs in exchange for Medicaid coverage of their outpatient prescription drugs, helping control costs for the program.
Referenced by (3)
Full triples — surface form annotated when it differs from this entity's canonical label.
linked to: Medicaid Drug Rebate Program