As a follow up to the notification sent on or around September 15, 2017 advising the Iowa Department of Human Services requiring the pharmacy reimbursement for Amerigroup Iowa Medicaid be modified to include submitted ingredient cost pricing and to remove Federal Upper Limit (FUL) pricing on all brand name drugs. Adjustments have been made to claims processed between April 1, 2016 through December 11, 2017.  

In addition, Iowa Medicaid has also retroactively reduced the dispensing fee from $11.73 to $10.02 for Amerigroup Iowa, Inc. member claims submitted on and after August 1, 2016. This adjustment only applies to claims submitted during the time period which were reimbursed with an $11.73 dispensing fee. Claims reimbursed at the Usual and Customary (U & C) price are not impacted.  

Adjustments for both changes are being processed simultaneously and will be seen on the next two remittance cycles.