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December 31, 2015IMPORTANT INFORMATION REGARDING Maximum Allowable Cost Pricing Review required by Effective January 1, 2016This notice is to provide you with information on the actions taken by Optimal

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What is maximum allowable cost pricing?

Maximum allowable cost pricing is a method used by pharmacy benefit managers to establish the maximum amount they will reimburse pharmacies for certain medications.

Who is required to file maximum allowable cost pricing?

Pharmacies and pharmacy benefit managers are required to file maximum allowable cost pricing.

How to fill out maximum allowable cost pricing?

Maximum allowable cost pricing is typically filled out using a designated pricing template provided by the pharmacy benefit manager.

What is the purpose of maximum allowable cost pricing?

The purpose of maximum allowable cost pricing is to control costs and ensure consistency in reimbursement rates for pharmacies.

What information must be reported on maximum allowable cost pricing?

Maximum allowable cost pricing typically requires pharmacies to report the cost of purchasing medications, as well as any applicable discounts or rebates.

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