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In 2018, the state of Oklahoma and the federal Centers for Medicare & Medicaid Services (CMS) worked to develop an outcome-based contract template for drug rebates to Medicaid, when authorized by a Medicaid State Plan Amendment. The Center’s SMART-D team partnered with these entities to offer research and technical assistance. 

Oklahoma was the first state to receive federal approval for work growing out of SMART-D and received significant national attention at the time of the announcement, including notable promotion by the federal government as a “first-of-its-kind” arrangement.

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