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40 states and Puerto Rico sign on to CMS's GENEROUS Medicaid drug-pricing model; the rest have until September 30

Published: Deadline: Federal

CMS announced on September 18, 2026 that 40 states and Puerto Rico have signed agreements to join the GENEROUS Model, its Medicaid drug-payment model that ties prices to what other wealthy countries pay, and that remaining states have until September 30, 2026 to sign. CMS estimates $64.3 billion in savings over ten years.

The model launched in January 2026 and runs for five years. The release does not list which states signed and says nothing about 340B or health centers, so any effect on health center pharmacy revenue is not addressed.

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Cite this analysis

FQHC Talent. (2026, September 18). 40 states and Puerto Rico sign on to CMS's GENEROUS Medicaid drug-pricing model; the rest have until September 30. Source: CMS press release (Sept. 18, 2026). Retrieved September 29, 2026, from https://www.fqhctalent.com/intel/cms-generous-medicaid-drug-model-40-states-september-2026

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