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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, the Indiana Family and Social Services Administration (FSSA) 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 continue the Medicaid dispensing fee maximum of $3 that is currently set to expire on June 30, 2013, for reimbursement to pharmacy providers under the Medicaid state plan and state regulations at 405 IAC 5-24, as amended by LSA Document #11-382(E), posted at 20110629-IR-405110382ERA. The Medicaid dispensing fee maximum of $3 will remain in effect through December 31, 2013. Beginning January 1, 2014, the OMPP proposes to increase the Medicaid dispensing fee maximum to $3.90.

The change in reimbursement is necessary in order 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 $14.3 million for FFY 2014 (federal share of $9.6 million and state share of $4.7 million) and $12.7 million for FFY 2015 (federal share of $8.5 million and state share of $4.2 million).

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

There will be no public hearing. Written comments may be directed to FSSA, Office of Medicaid Policy and Planning, Attention: Chris Johnson, Indiana Government Center South, 402 West Washington Street, Room W374, MS07, Indianapolis, IN 46207-7083. Correspondence should be identified in the following manner: COMMENT RE: PHARMACY DISPENSING FEE REIMBURSEMENT CHANGE. Written comments will be made available for public inspection at the address herein of the OMPP.

Debra F. Minott
Secretary
Family and Social Services Administration

Posted: 06/12/2013 by Legislative Services Agency

DIN: 20130612-IR-405130233ONA
Composed: Oct 01,2014 12:18:52PM EDT
A PDF version of this document.