Last fall, CMS approved the State Plan Amendment (SPA) for a new Medicaid fee-for-service reimbursement methodology. Subsequently, the Agency for Health Care Administration promulgated a final rule consistent with the approved SPA. Medicaid will begin reimbursing pharmacy providers using the new methodology on Friday, June 15. A subsequent provider alert will outline the plan for scheduling the reprocessing of pharmacy claims retroactive to April 1, 2017 in order to comply with the approved SPA.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.