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Alabama Medicaid Agency

Alabama Medicaid Agency. State MAC Program May 28, 2008. Alabama Medicaid Agency. Welcome and Introductions. 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.

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Alabama Medicaid Agency

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  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

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