Based on the annual survey conducted by the Department of Public Health, this year’s survey results provide data to support a proposed minimum dispensing fee of $5.11. Also, the maximum dispensing fee, for each volume range, is proposed to increase to incorporate the legislatively approved provider rate increase.
The Department of Public Health and Human Services issued a Notice of Public Hearing on Proposed Amendment to ARM 37.85.105, updating effective dates of Medicaid fee schedules effective July 1, 2023. The public hearing via remote conferencing will be held on July 27 at 9:00 a.m. Below are the proposed changes to pharmacy reimbursement.
(f)The outpatient drugs reimbursement dispensing fees range, as provided in ARM 37.86.1105(3)(b) is effective July 1, 2022 July 1, 2023:
(i) for pharmacies with prescription volume between 0 and 39,999, the minimum is $4.32 $5.11 and the maximum is $15.73 $16.36;
(ii) for pharmacies with prescription volume between 40,000 and 69,999, the minimum is $4.32 $5.11 and the maximum is $13.62 $14.16; or
(iii) for pharmacies with prescription volume greater than or equal to 70,000, the minimum is $4.32 $5.11 and the maximum is $11.52 $11.98.
(g) remains the same.
(h) The outpatient drugs reimbursement vaccine administration fee, as provided in ARM 37.86.1105(6), will be $21.32 for the first vaccine and $15.65 $18.65 for each additional administered vaccine, effective July 1, 2022 July 1, 2023.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.