La. Admin. Code tit. 50, § XXIX-945 - Reimbursement Methodology
A.
Maximum Pharmaceutical Price Schedule
1. The
maximum payment by the agency for a prescription shall be no more than the cost
of the drug established by the state plus the established professional
dispensing fee.
2.
Repealed.
B. Payment
will be made for medications in accordance with the payment procedures for any
fee-for-service (FFS) Medicaid eligible person.
C. The pharmacy must be licensed to operate
in Louisiana except:
1. as provided for a
person residing near the state line; or
2. as provided for a recipient visiting
out-of-state.
D. Payment
will be made only to providers whose records are subject to audit.
E. Payment will be made to providers only for
medications furnished to persons eligible for medical vendor payments on a
prescription written by a practitioner who is authorized to prescribe in
Louisiana and is enrolled in FFS Medicaid.
F. Payments will be made only for the drugs
covered under Louisiana Medicaids Pharmacy Program.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
A. Maximum Pharmaceutical Price Schedule
1. The maximum payment by the agency for a prescription shall be no more than the cost of the drug established by the state plus the established professional dispensing fee.
2. Repealed.
B. Payment will be made for medications in accordance with the payment procedures for any fee-for-service (FFS) Medicaid eligible person.
C. The pharmacy must be licensed to operate in Louisiana except:
1. as provided for a person residing near the state line; or
2. as provided for a recipient visiting out-of-state.
D. Payment will be made only to providers whose records are subject to audit.
E. Payment will be made to providers only for medications furnished to persons eligible for medical vendor payments on a prescription written by a practitioner who is authorized to prescribe in Louisiana and is enrolled in FFS Medicaid.
F. Payments will be made only for the drugs covered under Louisiana Medicaids Pharmacy Program.