Wednesday, February 25, 2015

AWP vs MAC for MSA Allocations


Beginning with Contract Year 2016 Medicare Pharmacy plans are to be reimbursed utilizing the Maximum Allowable Cost (MAC).  To date CMS has not incorporated MAC into their Medicare Set A-side review programs and continues to use the Average Wholesale Price (AWP) system that has found to overstate the drug pricing.  We hope to see a change in drug pricing for MSA allocations in the near future!
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