Alabama Medicaid Agency

1. Alabama Medicaid Agency State MAC Program May 28, 2008

2. Alabama Medicaid Agency • Welcome and Introductions

3. Alabama Medicaid Agency • ALMA Goals and Objectives for Pharmacy • Reimbursement • Better alignment of reimbursement to actual cost • Budget neutral impact to pharmacies and state budget

4. Alabama Medicaid Agency • Initiatives to meet goals and objectives • Cost of dispensing survey • State MAC rates based on average actual acquisition cost • Data gathered from Alabama Medicaid participating pharmacies • Future “Pharmacy First” concept

5. Alabama Medicaid Agency • Introduction of Myers and Stauffer • Company background • Pharmacy and State MAC program services

6. Alabama Medicaid Agency • State MAC Program Overview • Regularly survey Alabama Medicaid participating pharmacies • Compile, scrub and review acquisition cost data • Determine average acquisition cost • Apply a factor (multiplier) to average acquisition costs • Post State MAC rates • Address MAC rate concerns

7. Alabama Medicaid Agency • Survey Process • Survey letter requesting recent purchase history (A/P invoices) • Data submission by pharmacies • Copy and mail, or • Email electronic file(s)

8. Alabama Medicaid Agency • Survey Process (cont.) • Mandatory participation (no more often than once every two years) • Frequency of surveys (quarterly, semi-annual or annual) • Representative sample of pharmacies

9. Alabama Medicaid Agency Sample State MAC Rate Calculation

10. Alabama Medicaid Agency • Help Desk Contacts • Toll-free phone: (800) 591-1183 • Email: pharmacy@mslc.com • Fax: (317) 571-8481 • Web portal

11. Alabama Medicaid Agency • State MAC website • http://al.mslc.com

12. Alabama Medicaid Agency • ALMA Plan for Pharmacy Reimbursement • Better align reimbursement for ingredient and dispensing costs • Budget neutral – any savings will be used to reimburse pharmacists for cognitive services

13. Alabama Medicaid Agency • Discussion and Questions