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Deficit Reduction Act

Government Info

State and Local Government Officials Information

This page contains documents and links to important information for State and local officials to review and use as they implement the Deficit Reduction Act.  

Under "Downloads," please find the {1} Guide to Implementation of the DRA -- "Deficit Reduction Act:  Information for State Government Officials."  This publication contains brief descriptions and a checklist for many of the provisions contained in the DRA.  The publication will help State government officials in the executive and legislative branches in implementing the DRA.

Also under the "Downloads" section, you can find the {2} Legislative Checklist for DRA implementation -- "The Deficit Reduction Act:  Important Facts for State & Local Government Officials."  This package contains brief descriptions and checklists for many of the provisions contained in the DRA.  

Deficit Reduction Act:  Important Facts for State Policymakers

This series of documents is intended to provide State officials with additional information on specific provisions of the Deficit Reduction Act.

  • {3} Fighting Medicaid Fraud and Abuse:  The DRA included three provisions that address Medicaid program integrity and target fraud and abuse.
  • Updated! Tamper-Resistant Prescription Information:  Beginning April 1, 2008, all written prescriptions for outpatient drugs prescribed to a Medicaid beneficiary must be on paper with at least one tamper-resistant feature as outlined by CMS.  Beginning October 1, 2008 these same prescriptions must be on paper that meets all three baseline characteristics of tamper-resistant pads.  Links can be found below to the {4} State Medicaid Directors Letter, the {5} background document for State Health Policymakers (updated as of 7/15/08), the {6} Top Questions about Tamper-Resistant Prescriptions (updated as of 7/15/08), and a {12} Pharmacist Fact Sheet (updated as of 7/15/08).  
  • {7} Health Opportunity Accounts:  The DRA establishes a new demonstration program that allows States to offer "health opportunity accounts" -- savings accounts that can be used to pay for medical expenses in conjunction with a high deductible health plan.
  • {8} Third Party Liability in the Medicaid Program:  The DRA made a number of changes intended to strengthen states' ability to identify and collect mistaken Medicaid payments from liable third party payers.
  • {9} Transfer of Assets: The DRA introduced new rules to the Medicaid program to discourage the improper transfer of assets to gain Medicaid eligibility and coverage of long-term care services.
  • {10} State Flexibility in Benefit Packages: States now have the opportunity to provide different "benefit packages" to certain populations.  These benefit packages do not need to follow Medicaid's traditional rules requiring statewideness, freedom of choice, or comparability.
  • {11} Medicaid Cost-Sharing & Premiums:  States have new options to impose cost-sharing charges and premiums on certain Medicaid recipients through new flexibilities introduced in the DRA and clarified in the Tax Relief and Health Care Act of 2006.


{1} Guide to Implementation of the DRA [PDF, 99KB]

{2} Legislative Checklist for DRA Implementation [PDF, 64KB]

{3} Fighting Medicaid Fraud and Abuse [PDF, 30 KB]

{5} Medicaid Tamper-Resistant Prescription Information [PDF, 38 KB]

{6} Top Questions about Tamper-Resistant Prescriptions [PDF, 235KB]

{7} Health Opportunity Accounts [PDF, 79 KB]

{8} Third Party Liability in the Medicaid Program [PDF, 22KB]

{9} Transfer of Assets [PDF, 49KB]

{10} State Flexibility in Benefit Packages [PDF, 33KB]

{11} Medicaid Cost-Sharing & Premiums [PDF, 31KB]

{12} Medicaid Prescription Resistant Prescription Pad Law -- Pharmacist Fact Sheet [PDF, 41KB]

Related Links Inside CMS

{4}State Medicaid Directors Letter
Related Links Outside CMSExternal Linking Policy

There are no Related Links Outside CMS


Page Last Modified: 07/15/2008 4:14:04 PM
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