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Final AMP-based FULs coming soon

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The National Association of Chain Drug Stores reports that final average manufacturer price (AMP)-based federal upper limits (FULs) are set to be published by the Centers for Medicare & Medicaid Services (CMS) late this month.

seniors WAG pharmacy_featuredOnce instituted, the final AMP-based FULs will “significantly change” Medicaid pharmacy reimbursement for branded and generic drugs, according to NACDS.

CMS issued the Covered Outpatient Drugs final rule with comment in January. The rule (CMS-2345-FC) addresses key areas of Medicaid drug reimbursement and changes made to the Medicaid Drug Rebate Program by the Affordable Care Act.

NACDS noted that it’s continuing to work with in-state partners to assess state activities on the implementation of the upcoming finalized AMP-based FULs, the adoption of the cost-based reimbursement provisions of the final rule, and the transition to “fair and accurate” dispensing fees. The association, too, said it’s looking at how states have implemented acquisition cost-based reimbursement.

Final AMP-based FULs go into effect on April 1. Once the rule is published, states will have up to 30 days from the April 1 effective date to implement the FULs, but NACDS noted that states will have until April 2017 to move to cost-based product reimbursement and adjust dispensing fees.


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