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States vary in their regulations of pharmaceuticals. This tables
indicates which states regulate pharmaceutical fees as of January of
2008; whether they require substitution of generic drugs; the basis of
the maximum allowable fee; the maximum dispensing fees if appropriate;
if they limit the length or dosage of narcotics; and the reference for
the regulations should the reader need more information. |
|
State |
Substitution of Generic Drugs Required |
Basis of the Maximum Allowable Prescription Fee |
Same Maximum Fee for Generic Applies to: |
Maximum Allowable Dispensing Fees for Generic (if Applicable) |
Maximum Allowable Dispensing Fees for Brand Names (if Applicable) |
Percentage of Usual and Customary (if Applicable) |
Limitations on Length or Use or Dosage for Narcotics? |
Title and Rule Number of Pharmaceutical Fee Regulations |
|
Average Wholesale Price Plus a Maximum Dispensing Fee |
State Medicaid Fee Schedule |
Other |
Inpatient Hospitals |
Outpatient Hospitals |
Urgent Care Centers |
Retail Pharmacy |
Physician's Office or Clinic |
|
Sample State 1 |
Allowed, but not required |
x |
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AWP + 40% and $5.77 dispensing fee |
AWP + 10% and $5.77 dispensing fee |
n/a |
None |
Title 40, Chapter 29 of the Maximum Fee Allowance Schedule |
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Sample State 2 |
Yes |
x |
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$7.92 |
$7.92 |
n/a |
None |
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Notes: |
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