37.86.1106    CALCULATION OF THE AVERAGE ACQUISITION COST

(1) The Average Acquisition Cost (AAC) is the cost per drug determined by direct pharmacy survey, wholesale survey, and other relevant cost information.

(a) The department reviews AAC rates on an ongoing basis and adjusts the rates as necessary to reflect prevailing market conditions and ensure reasonable access by providers to drugs at or below the applicable AAC rate.

(b) Pharmacies and providers that are enrolled in Montana Medicaid are required, as a condition of participation, to submit, upon request, to the department, or its designee, acquisition cost information, product availability information, and other information deemed relevant by the department for the efficient operation of the pharmacy benefit. Information is provided in the format requested by the department or its designee. Providers are not reimbursed for this information and must submit information to the department or its designee within 30 days following a request for such information unless the department or its designee grants an extension upon written request of the pharmacy or provider.

History: 53-6-101, 53-6-113, MCA; IMP, 53-6-101, 53-6-113, MCA; NEW, 2010 MAR p. 433, Eff. 3/1/10; AMD, 2011 MAR p. 2416, Eff. 11/11/11; AMD, 2016 MAR p. 1065, Eff. 7/1/16.