The new legislation, along with a similar bill (HB 765), undermines the use of Maximum Allowable Cost (MAC) generic drug lists that employers and public programs use to prevent them from overpaying for generic drugs and could increase Florida's prescription drug costs by $422.
In the generic market, each pharmacy benefit manager has its own maximum allowable cost lists and, in many instances, determines its own maximum prices, which the pharmacy benefit manager updates from time to time.
States are to pay pharmacies the lower of the state's estimate of the drug's acquisition cost to the pharmacy, plus a dispensing fee, or the pharmacy's usual and customary charge to the general public; for certain drugs, the FUL or the state maximum allowable cost (MAC) may apply if lower.
Unclear generic drug pricing and maximum allowable cost payment calculations -- "While MAC list pricing is not the genesis of, nor the solution to, price volatility in the generic market, providing updated MAC prices in advance of reimbursement, in a timely manner, can help to avoid situations in which a pharmacy is under-reimbursed for a prescription due to large fluctuations in price.
Components Of The Audit Include But Are Not Limited To: Comparison Of Claims Invoice And Amounts Paid By The Commonwealth To: 1) Price Lists, Such As Maximum Allowable Cost (mac), Maximum Reimbursable Amount (mra), Average Wholesale Price (awp), Etc.