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The Bush administration this week proposed a rule that would cut reimbursements to pharmacists for prescription drugs for Medicaid beneficiaries.

The rule would save $8.4 billion ($4.9 in federal savings and $3.5 billion in state savings) over the next five years. It is designed to ensure that Medicaid can obtain drug discounts similar to those obtained by private entities, such as pharmacy benefits managers.

Other aspects of the rule: It would redefine “average manufacturer price” for brand-name and generic drugs. States use the average manufacturer price to calculate Medicaid reimbursement rates for drugs. The rule also would limit the federal government’s share of the cost of a prescription drug when at least three generic alternatives are available. A 60-day comment period is in effect.