Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.18-010 - State Plan Amendment 2018-012-Pharmacy

Current through Register Vol. 49, No. 6, June, 2024
ATTACHMENT 3.1-A
STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT
				MEDICAL ASSISTANCE PROGRAM STATE
ARKANSAS
AMOUNT, DURATION AND SCOPE OF SERVICES
				PROVIDED
12. Prescribed drags,
			 dentures and prosthetic devices; and eyeglasses prescribed by a physician
			 skilled in diseases of the eye or by an optometrist
a. Prescribed Drags
(4) The state is in compliance with section
			 1927 of the Social Security Act. The state will cover drags of Federal rebate
			 participating manufacturers. The state is in compliance with reporting
			 requirements for utilization and restrictions to coverage. Pharmaceutical
			 manufacturers can audit utilization data.
The state will be negotiating supplemental rebates in the
				Medicaid program in addition to the Federal rebates provided for in Title XIX.
				Rebate agreements between the state and pharmaceutical manufacturer(s) will be
				separate from the Federal rebates.
A rebate agreement between the state and a participating drag
				manufacturer for drags provided to the Medicaid program, submitted to CMS on
				May 24,2016, and entitled, State of Arkansas Supplemental Rebate Agreement, has
				been authorized by CMS. Any additional versions of rebate agreements negotiated
				between the state and manufacturer(s) after May 24, 2016, will be submitted to
				CMS for authorization.
The state supplemental rebate agreements would apply to
				the drug benefit, both fee-for-service and those paid by contracted Medicaid
				managed care organizations (MCOs), under prescribed conditions in Attachment C
				of the State of Arkansas Supplemental Rebate Agreement. State supplemental
				rebate agreements would apply to beneficiaries, including those made eligible
				under the Affordable Care Act receiving fee-for-service benefits and those that
				are enrolled under a Medicaid managed care organization
				agreement.
Supplemental rebates received by the State in excess of those
				required under the National Drag Rebate Agreement will be shared with the
				Federal government on the same percentage basis as applied under the national
				rebate agreement.
All drags covered by the program, irrespective of a
				supplemental rebate agreement, will comply with the provisions of the national
				drag rebate agreement.
The supplemental rebate program does not establish a drag
				formulary within the meaning of 1927(d)(4) of the Social Security Act.
The unit rebate amount is confidential and cannot be disclosed
				for purposes other than rebate invoicing and verification, in accordance with
				Section 1927(b)(3)(D) of the Social Security Act.
(5) Pursuant to
			 42 U.S.C. Section
			 1396r-8 the state is establishing a preferred
			 drag list with prior authorization for drags not included on the preferred drag
			 list. Prior authorization will be provided within a 24-hour turn-around from
			 receipt of request and a 72-hour supply of drags in emergency situations.
ATTACHMENT 3.1-B
STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT
				MEDICAL ASSISTANCE PROGRAM STATE
ARKANSAS