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Kentucky Maximum Allowable Cost (MAC) List Policy Purpose This Policy is for compliance with Kentucky Law as set forth at MRS 304.17A162 and 806 CAR 17:575. Scope This Policy is applicable to those
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Kentucky Maximum Allowable Cost is needed by individuals or entities who are seeking to determine the maximum allowable cost for specific insurance policies in the state of Kentucky. This form is typically used by insurance companies, agents, or policyholders who want to comply with the regulations set by the Kentucky Department of Insurance. It helps in determining the maximum amount that can be charged for certain services or procedures covered by insurance, ensuring fair and reasonable costs for policyholders.
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The Kentucky Maximum Allowable Cost (MAC) is a regulation that establishes the maximum price that state Medicaid programs are willing to pay for specific prescription drugs.
Pharmacies and healthcare providers that bill Medicaid services are required to file the Kentucky Maximum Allowable Cost.
To fill out the Kentucky MAC, providers must include information regarding the drugs dispensed, the corresponding costs, and any other relevant billing details as specified by the Kentucky Medicaid program.
The purpose of Kentucky MAC is to control Medicaid drug spending and ensure that payments for medications are consistent and reasonable.
Providers must report the National Drug Code (NDC), drug name, dosage form, and the price for each prescription drug.
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