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OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES

Notice of Changes in Methods and Standards for Medicaid Payments for Providers of Pharmacy Services


In accordance with public notice requirements of 42 CFR 447.205 and Section 1902(a)(13(A) of the Social Security Act, the Indiana Family and Social Services Administration, Office of Medicaid Policy and Planning (OMPP) publishes this notice of proposed changes to the reimbursement methodology for Medicaid services provided by enrolled pharmacy providers.

The OMPP proposes to modify reimbursement formulas by reducing the Medicaid dispensing fee maximum currently paid to pharmacy providers under the Medicaid state plan and state regulations at 405 IAC 5-24 from four dollars and ninety cents ($4.90) to three dollars ($3). This reduction shall be effective July 1, 2011, and continue through June 30, 2013.

This change in reimbursement is necessary in order to avoid a budgetary shortfall and to remain within the available Medicaid appropriation. It is estimated that the fiscal impact of these changes will be annual savings of state and federal expenditures of approximately $22 million for SFY 2012 and $22.7 million for SFY 2013.

These changes will be adopted in an emergency rule. A copy of this notice is now on file at the Indiana Government Center South, 402 West Washington Street, Room W451, Indianapolis, Indiana and open for public inspection. Also, a copy of this notice is now available and may be inspected by contacting the local county division of family resources office, except in Marion County, where public inspection may be made at 402 West Washington Street, Room W374, Indianapolis, Indiana.

The proposed changes and proposed rate are available on the Internet at:
http://in.mslc.com
Interested parties without Internet access should contact Myers and Stauffer, LC at (800) 877-6927 to obtain copies of the proposed changes and proposed rate.

Anyone who wishes to comment on the proposed changes may submit written comments to: IFSSA, Office of Medicaid Policy and Planning, Attention: David Testerman, 402 West Washington Street, Room W374, P.O. Box 7083, Indianapolis, IN 46207-7083. Correspondence should be identified in the following manner: COMMENT RE: PHARMACY DISPENSING FEE REIMBURSEMENT CHANGE. Written comments received will be made available for public display at the address herein of the OMPP.

Michael A. Gargano
Secretary
Family and Social Services Administration

Posted: 06/29/2011 by Legislative Services Agency

DIN: 20110629-IR-405110387ONA
Composed: May 04,2024 5:36:52PM EDT
A PDF version of this document.