LAC 50:XXIX.945. Reimbursement Methodology

A. Maximum Pharmaceutical Price Schedule 1. The maximum payment by the agency for a prescription shall be no more than the cost of the drug established by the state plus the established professional dispensing fee. B. Payment will be made for medications in accordance with the payment procedures for any fee-for-service (FFS) Medicaid eligible person. C. The pharmacy must be licensed to operate in Louisiana except: 1. as provided for a person residing near the state line; or 2. as provided for a recipient visiting out-of-state. D. Payment will be made only to providers whose records are subject to audit. E. Payment will be made to providers only for medications furnished to persons eligible for medical vendor payments on a prescription written by a practitioner who is authorized to prescribe in Louisiana and is enrolled in FFS Medicaid. F. Payments will be made only for the drugs covered under Louisiana Medicaid’s Pharmacy Program.