1. A. Maximum Pharmaceutical Price Schedule

   1. 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.
2. B. Payment will be made for medications in accordance with the payment procedures for any fee-for-service (FFS) Medicaid eligible person.

3. C. The pharmacy must be licensed to operate in Louisiana except:

   1. 1. as provided for a person residing near the state line; or
   2. 2. as provided for a recipient visiting out-of-state.
4. D. Payment will be made only to providers whose records are subject to audit.
5. 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.
6. F. Payments will be made only for the drugs covered under Louisiana Medicaid’s Pharmacy Program.

Authority Note

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

Historical Note

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 32:1064 (June 2006), amended LR 34:88 (January 2008), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 36:1561 (July 2010), amended by the Department of Health, Bureau of Health Services Financing, LR 43:1184 (June 2017), LR 45:571 (April 2019).