Fast Facts Medicaid programs that cover prescription drugs are generally required to cover drugs that are (1) FDA approved and (2) made by a manufacturer that participates in the Medicaid Drug Rebate Program. 13 Medicaid programs didn’t cover Mifeprex and its generic equivalent, Mifepristone Tablets, 200 mg, when required. These drugs are used for medical abortion. We recommended the Centers for Medicare & Medicaid Services ensure Medicaid programs comply with federal requirements for covering Mifepristone Tablets, 200 mg. We also reiterated our 2019 recommendation on Mifeprex, which hasn’t been implemented. White pills spilling from a pill bottle. Skip to Highlights Highlights What GAO Found Medicaid programs that choose to cover outpatient prescription drugs are required to cover all Food and Drug Administration (FDA) approved drugs for their medically accepted indications when those drugs are made by a manufacturer that participates in the Medicaid Drug Rebate Program (MDRP), except as outlined in federal law. The FDA has approved two drugs—Mifeprex in 2000 and its generic equivalent in 2019, referred to as Mifepristone Tablets, 200 mg—for the medical termination of an intrauterine pregnancy, known as a medical abortion. Danco Laboratories and GenBioPro are the exclusive manufacturers of Mifeprex and Mifepristone Tablets, 200 mg, respectively, and both manufacturers participate in the MDRP. Medicaid programs in all 50 states, the District of Columbia, and Puerto Rico cover prescription drugs and participate in the MDRP. According to officials from the Centers for Medicare & Medicaid Services (CMS)—the federal agency within the Department of Health and Human Services (HHS) responsible for ensuring Medicaid programs’ compliance—none of the MDRP’s statutory exceptions apply to Mifeprex or Mifepristone Tablets, 200 mg. Thus, these 52 Medicaid programs must cover these drugs when prescribed for medical abortion in circumstances eligible for federal funding, such as when the pregnancy is the result of rape or incest. GAO identified gaps in Medicaid programs’ coverage of Mifeprex and Mifepristone Tablets, 200 mg. Officials from 35 of the 49 programs who responded to GAO questions said their programs covered Mifeprex and Mifepristone Tablets, 200 mg for medical abortion, as of December 31, 2024. In contrast, officials from 13 programs told GAO their programs did not cover either drug for medical abortion. An official from the remaining program did not specify the medical indications for which its program covered the drugs. Medicaid Programs’ Coverage of Danco Laboratories’ Mifeprex and GenBioPro’s Mifepristone Tablets, 200 mg, as of December 31, 2024 Note: For more details, see fig. 1 in GAO-25-107911. State officials’ responses to GAO’s questions indicated that some states may not be complying with the MDRP requirements for covering Mifeprex and Mifepristone Tablets, 200 mg. However, CMS has not determined the extent to which states comply with the MDRP requirements for these drugs. CMS officials told GAO they were not aware of the following: Nine programs did not cover Mifeprex and Mifepristone Tablets, 200 mg for any medical indication, as of December 31, 2024; GAO reported four of these programs did not cover Mifeprex in 2019. Mifepristone Tablets, 200 mg was not available at the time of GAO’s 2019 report. Four additional Medicaid programs did not cover either drug when prescribed for medical abortion, as of December 31, 2024. CMS was not aware of these coverage gaps, in part, because it had not implemented GAO’s 2019 recommendation to take actions to ensure Medicaid programs comply with MDRP requirements to cover Mifeprex. CMS also has not taken actions related to the coverage of Mifepristone Tablets, 200 mg, as of August 2025. Without such actions, CMS lacks assurance that Medicaid programs comply with MDRP requirements and Medicaid beneficiaries may lack access to these drugs when appropriate. Why GAO Did This Study GAO was asked to describe Medicaid programs’ coverage of mifepristone. This report examines Medicaid programs’ coverage of Mifeprex and Mifepristone Tablets, 200 mg, among other things. GAO reviewed laws and CMS guidance on the MDRP, and coverage of Mifeprex and Mifepristone Tablets, 200 mg. GAO also sent written questions to officials from the 52 Medicaid programs that participate in the MDRP regarding their coverage of these drugs, and reviewed officials’ responses from the 49 programs that provided GAO information. Recommendations GAO reiterates its 2019 recommendation that CMS take actions to ensure states’ compliance with MDRP requirements to cover Mifeprex. GAO also recommends that CMS determine the extent to which states comply with federal Medicaid requirements regarding coverage of GenBioPro’s Mifepristone Tablets, 200 mg, and take actions, as appropriate, to ensure compliance. In response to the recommendation, HHS noted it is reviewing applicable law and will determine the best course of action to address it moving forward. Recommendations for Executive Action Agency Affected Recommendation Status Centers for Medicare & Medicaid Services The Administrator of CMS should determine the extent to which states comply with federal Medicaid requirements regarding coverage of GenBioPro's Mifepristone Tablets, 200 mg, and take actions, as appropriate, to ensure compliance. (Recommendation 1) Open Actions to satisfy the intent of the recommendation have not been taken or are being planned. When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information. Full Report Full Report (11 pages)

October 31, 2025 Canada’s Minister for Energy and Natural Resources Tim Hodgson and Italy's Minister of the Environment and Energy Security Gilberto Pichetto Fratin met today on the margins of the G7 Energy and Environment Ministerial Meeting in Toronto to formally launch the Canada-Italy bilateral Energy Dialogue. The Ministers jointly decided the Energy Dialogue will serve as a coordination mechanism to advance shared energy and natural resources priorities highlighted under the June 2025 Joint Statement by Prime Minister Mark Carney and President of the Council of Ministers Giorgia Meloni, and future initiatives that may be identified. The Ministers welcomed the recent Canada Trade Mission to Italy, which included energy and clean technology amongst its priority sectors and looked forward to the proposed reciprocal visit to Canada by Italian companies for a Business Forum in 2026. Critical minerals cooperation: Recognizing the essential role that critical minerals play in energy security, clean technology and defence, Canada and Italy are committed to enhancing cooperation on critical minerals and critical raw materials, in line with the Joint Statement on Critical Minerals and Critical Raw Materials. In this regard, the Ministers discussed the excellent collaboration already achieved under the Critical Minerals Production Alliance, and to build on this momentum by deploying sovereign tools, mobilizing private and public capital as well as securing offtake arrangements to accelerate the development of responsible, secure, resilient critical minerals supply chains that power the clean energy transition. Nuclear cooperation: Recognizing the role of nuclear energy in achieving net-zero goals, Canada and Italy committed to continue exploring opportunities for scientific, regulatory, and industrial collaboration, leveraging both countries’ sectorial activities and expertise. Cooperation on other energy sectors: The Ministers also jointly decided that the Energy Dialogue would be used to advance cooperation in other areas such as LNG, sustainable fuels including renewable and low carbon hydrogen and sustainable biofuels, renewables technologies, decarbonization and carbon management. In this regard, the Ministers welcomed the recent signature of a Memorandum of Understanding between the Canadian Hydrogen Association (CHA) and the Italian Hydrogen Association (H2IT). Follow up: The Ministers have committed to regular engagement on these and other emerging energy issues through the Energy Dialogue at Senior Officials’ level in the coming months. The next one is expected to take place on the margins of the Prospectors & Developers Association of Canada Convention from March 1-4, 2026, in Toronto. The Ministers encouraged Senior Officials to consider how to engage private industry and thought leaders in future sector specific discussions. The Ministers also announced plans to carry out trade missions to Canada and Italy in the coming months to advance commercial ties for mutual benefit. Our Statement of Intent today demonstrates the strong mutual commitment to partnership in an area vital to the economic prosperity and security of both countries. The Ministers noted their strong interest to concretely advance important initiatives to further deepen this longstanding and evolving bilateral relationship.

In 2023 we funded a three-year research project to understand and track changes in people’s attitudes, awareness and behaviours around waste minimisation. This third and final report focused on: • recycling and reducing behaviours • food waste • plastics • communications around reducing waste. Find out more about the survey results and the research project on our Research into attitudes to waste and recycling web page. PDF download,2025 waste and resource efficiency behavioural trend monitoring report, 4.1 MB In 2023 we funded a three-year research project to understand and track changes in people’s attitudes, awareness and behaviours around waste minimisation. This third and final report focused on: • recycling and reducing behaviours • food waste • plastics • communications around reducing waste. Find out more about the survey results and the research project on our Research into attitudes to waste and recycling web page.