2

Sep

2016

Magellan: Addition of Maxium Allowable Cost (MAC) Pricing to Diabetic Supplies

Effective: September 5, 2016

Addition of Maximum Allowable Cost (MAC) Pricing to Diabetic Supplies Magellan Medicaid Administration implemented a new MAC to all lancets effective August 24, 2016. Additionally, all other diabetic supplies will be subject to MAC pricing effective September 5, 2016. Please make a note of the new pricing below to ensure that you are purchasing and billing for the lowest cost alternative for these supplies.

29

Feb

2016

CVS/caremark: Reminder Medicare Part D: Maximum Allowable Cost (MAC) Inquiry Enhancements

Effective: January 1, 2016

Effective January 1, 2016, in accordance with the Centers for Medicare and Medicaid Services (CMS) regulations in ยงยง 423.501, 423.505(b)(21), and 423.505(i)(3)(viii) Part D plans are required to disclose to pharmacies MAC prices to be updated in advance of their use for reimbursement of claims. To comply with these requirements, CVS/caremark Part D Services has implemented enhancements to its Pharmacy Portal/MAC inquiry tool, located at https://rxservices.cvscaremark.com/. The following is intended to assist pharmacies when navigating within the Pharmacy Portal in order to use the Medicare Part D MAC enhancements that will be effective on January 1, 2016.

5

Feb

2016

Tmesys: Notification of Update to Tmesys MAC Pricing

Dear Pharmacy Provider, Pursuant to state MAC regulations, please consider this to be notification that Tmesys has reviewed and instated a new MAC pricing list. Tmesys MAC pricing is determined by a third party vendor, Glass Box Analytics LLC, using the Predictive Acquisition Cost (PAC) model. PAC pricing uses the following sources: industry MAC Benchmarks, published price lists, existing pricing benchmarks, behavioral metrics, and supply/demand measures. PAC pricing also uses as a "source", survey based drug acquisition costs obtained from CMS on the national level and pharmacy level pricing information as reported to state agencies from the following states: Arkansas, Colorado, Idaho, Louisiana, and Oregon. Helios strives to ensure compliance with all state legislative and regulatory requirements related to the provision of pharmacy and ancillary services. Therefore, to receive information pursuant to, and compliant with these regulations, interested Tmesys network pharmacies should fill out the MAC Inquiry Form and Non-Disclosure Agreement that can be accessed via the Helios website and email the completed forms to MACresolution@helioscomp.com. Thank you, Tmesys

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