On March 23, 2018, the Centers for Medicare and Medicaid Services (CMS) published Final Notice that implements a substantially revised Medicaid National Drug Rebate Agreement (NDRA). All agreements currently in place will expire on October 1, 2018, and CMS is requiring participating manufacturers to execute and return the new NDRA no later than September 30, 2018, as a condition of remaining in the Medicaid Drug Rebate Program (MDRP).