CMS Drops New Medicaid Drug Spending Data Trove
Published Date: 7/23/2026
Notice
Summary
CMS is releasing new, easy-to-use data about Medicaid drug spending to help everyone spot fraud and waste while keeping sensitive info safe. This update builds on past releases and makes drug payment info clearer and more open, starting soon. It’s a big win for transparency and helps taxpayers see how their money is spent without costing extra.
Analyzed Economic Effects
3 provisions identified: 2 benefits, 1 costs, 0 mixed.
Public release of Medicaid drug spending
CMS will publish a new public data asset called "Medicaid Provider Spending by National Drug Code (NDC)" covering January 2018 through December 2024. Each row shows a billing-provider NPI, prescribing-provider NPI, NDC, claim month, number of unique beneficiaries, number of claim lines, and total Medicaid paid amount to help the public spot fraud, waste, and abuse.
Provider enrollment records made public
CMS will publish a data asset called "Medicaid Provider Enrollment Segments" covering January 2018 through December 2024 that shows when a provider was enrolled in Medicaid in a State, DC, or a Territory, the provider's enrollment status, whether the enrollment was Medicaid, CHIP, or both, and the provider type. This makes provider-level enrollment information available for public inspection.
Data caveats and privacy protections
The released Medicaid drug spending data were de-identified, apply disclosure avoidance techniques, and suppress rows that represent fewer than 12 unique beneficiaries. The asset is built from final-action claim lines dated January 2018 through December 2024 and may include denied claims; repeated-digit placeholder codes represent missing values and should be excluded from analyses.
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Key Dates
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