(1) The Centers for Medicare and Medicaid
Services (CMS) Federal Upper Limits for Drug Payments listing of multiple
source drugs meets the criteria set forth in 42 CFR
447.332 and 1927(e) of the
Act as amended by OBRA 1993 and the DRA 2005.
(2) Payments for multiple source drugs must
not exceed, in the aggregate, payment levels determined by applying to each
drug entity a reasonable dispensing fee (established by the State and specified
in the State Plan), plus an amount based on the limit per unit. CMS has
determined the amount based on the limit per unit to be equal to 250 percent of
the Average Manufacturer's Price (AMP). CMS will post the AMP to a Website
available to the public on a quarterly basis.
(3) The FUL drug listing is published in the
State Medicaid Manual, Part 6, Payment for Services, Addendum A. The most
current Transmittals and subsequent changes are posted to the CMS website
https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing/index.html
[File Link Not Available].
Notes
Or. Admin. Code
§
410-121-0300
AFS 56-1989, f. 9-28-89,
cert. ef. 10-1-89; AFS 63-1989(Temp), f. & cert. ef. 10-17-89; AFS 79-1989,
f. & cert. ef. 12-21-89; HR 3-1990(Temp), f. & cert. ef. 2-23-90; HR
13-1990, f. & cert. ef. 4-20-90, Renumbered from 461-016-0330; HR 20-1990,
f. & cert. ef. 7-9-90; HR 29-1990, f. 8-31-90, cert. ef. 9-1-90; HR
45-1990, f. & cert. ef. 12-28-90; HR 10-1991, f. & cert. ef. 2-19-91;
HR 37-1991, f. & cert. ef. 9-16-91; HR 13-1992, f. & cert. ef. 6-1-92;
HR 28-1992, f. & cert. ef. 9-1-92; HR 35-1992(Temp), f. & cert. ef.
12-1-92; HR 1-1993(Temp), f. & cert. ef. 1-25-93; HR 3-1993, f. & cert.
ef. 2-22-93; HR 5-1993(Temp), f. 3-10-93, cert. ef. 3-22-93; HR 8-1993(Temp),
f. & cert. ef. 4-1-93; HR 11-1993, f. 4-22-93, cert. ef. 4-26-93; HR
15-1993(Temp), f. & cert. ef. 7-2-93; HR 20-1993, f. & cert. ef.
9-1-93; HR 25-1993(Temp), f. & cert. ef. 10-1-93; HR 14-1994, f. &
cert. ef. 3-1-94; HR 25-1994, f. & cert. ef. 7-1-94; HR 2-1995, f. &
cert. ef. 2-1-95; HR 6-1995, f. 3-31-95, cert. ef. 4-1-95; HR 14-1995, f.
6-29-95, cert. ef. 7-1-95; HR 23-1995, f. 12-29-95, cert. ef. 1-1-96; HR
22-1997, f. & cert. ef. 10-1-97; HR 27-1997, f. & cert. ef. 12-1-97;
OMAP 2-1998, f. 1-30-98, cert. ef. 2-1-98; OMAP 43-1998(Temp), f. & cert.
ef. 11-20-98 thru 5-1-99; OMAP 5-1999, f. & cert. ef. 2-26-99; OMAP
42-2000(Temp), f. & cert. ef. 12-15-00 thru 5-1-01; OMAP 1-2001(Temp), f.
& cert. ef. 2-1-01 thru 6-1-01; OMAP 2-2001(Temp), f. 2-14-01, cert. ef.
2-15-01 thru 7-1-01; OMAP 18-2001, f. 3-30-01, cert. ef. 4-1-01; OMAP
23-2001(Temp), f. & cert. ef. 4-16-01 thru 8-1-01; OMAP 26-2001(Temp), f.
& cert. ef. 6-6-01 thru 1-2-02; OMAP 51-2001(Temp) f. 9-28-01, cert. ef.
10-1-01 thru 3-15-01; OMAP 58-2001, f. 11-30-01, cert. ef. 12-1-01; OMAP
67-2001(Temp), f. 12-28-01, cert. ef. 1-1-02 thru 5-15-02; OMAP 3-2002(Temp),
f. & cert. ef. 2-15-02 thru 6-15-02; OMAP 5-2002(Temp) f. & cert. ef.
3-5-02 thru 6-15-02; OMAP 19-2002(Temp), f. & cert. ef. 4-22-02 thru
9-15-02; OMAP 29-2002(Temp), f. 7-15-02, cert. ef. 8-1-02 thru 1-1-03; OMAP
71-2002(Temp), f. & cert. ef. 12-1-02 thru 5-15-03; OMAP 10-2003, f.
2-28-03, cert. ef. 3-1-03; OMAP 11-2003(Temp), f. 2-28-03, cert. ef. 3-1-03
thru 8-15-03; OMAP 41-2003, f. & cert. ef. 5-29-03; OMAP 51-2003, f. &
cert. ef. 8-5-03; OMAP 54-2003(Temp), f. & cert. ef. 8-15-03 thru 1-15-03;
OMAP 75-2003, f. & cert. ef. 10-1-03; OMAP 83-2003(Temp), f. 11-25-03,
cert. ef. 12-1-03 thru 4-15-04; OMAP 2-2004, f. 1-23-04, cert. ef. 2-1-04; OMAP
32-2004(Temp), f. & cert. ef. 5-14-04 thru 10-15-04; OMAP 43-2004, f.
6-24-04 cert. ef. 7-1-04; OMAP 93-2004(Temp), f. & cert. ef. 12-10-04 thru
5-15-05; OMAP 2-2005, f. 1-31-05, cert. ef. 2-1-05; OMAP 23-2005(Temp), f.
& cert. ef. 4-1-05 thru 9-1-05; OMAP 29-2005, f. & cert. ef. 6-6-05;
OMAP 56-2005, f. 10-25-05, cert. ef. 11-1-05; OMAP 59-2005(Temp), f. 11-8-05,
cert. ef. 11-12-05 thru 5-1-06; OMAP 68-2005, f. 12-21-05, cert. ef. 1-1-06;
OMAP 8-2006(Temp), f. 3-29-06, cert. ef. 4-1-06 thru 9-15-06; OMAP 13-2006, f.
5-26-06, cert. ef. 6-1-06; OMAP 50-2006, f. 12-28-06, cert. ef. 1-1-07; DMAP
26-2007, f. 12-11-07, cert. ef. 1-1-08; DMAP 36-2008, f. 12-11-08, cert. ef.
1-1-09;
DMAP
37-2018, minor correction filed 05/25/2018, effective
5/25/2018
Statutory/Other Authority: ORS
413.042 &
414.065
Statutes/Other Implemented: ORS
414.065
