Pharmacy Reimbursement Methodology

General questions: dmap.rxquestions@state.or.us

DMAP Pharmaceutical services program info

 

The Oregon Health Authority's Division of Medical Assistance Programs (DMAP) now compensates OHP fee-for-service pharmacies according to an Average Actual Acquisition Cost (AAAC) reimbursement model. The goal of the model is to establish a transparent, timely and accurate pharmacy reimbursement system based on the actual cost (invoice) to the pharmacy for the drug dispensed plus a statistically validated dispensing fee.

Please continue to use this site to learn more about this new program and other pharmacy-based initiatives the Oregon Health Authority is developing. The following documents will provide more detailed information:

• Average Actual Acquisition Cost Program
• Background and supporting documents
• Non-disclosure agreement

Average Actual Acquisition Cost (AAAC) Program Information

• AAAC Questions and Answers — For enrolled DMAP pharmacies
  
  
• Weekly AAAC Rate Listing for Brand Drugs
  • This week
  • Last week
     
    
• Weekly AAAC Rate Listing for Generic Drugs
  • This week
  • Last week

Background and supporting documents

• DMAP's original State Plan Amendment and CMS Letter of Approval to implement AAAC reimbursement and despensing fee tiers.
• Report - Survey of Dispensing Costs of Pharmaceuticals in the State of Oregon.
• Original State Plan Amendment to change thresholds on dispensing fee tiers and CMS Letter of Approval.

Non-disclosure agreement

If you wish to have a non-disclosure agreement (NDA) between the Oregon Health Authority and your pharmacy with respect to the pricing and volume surveys being conducted by Myers and Stauffer, LC:

• Print the non-dislosure agreement form, fill in the name of your pharmacy, and sign the document.
• Enrolled DMAP pharmacies -- Scan the document and send it to Valerie Smith at Valerie.M.Smith@state.or.us. 
  You can also fax the document to Valerie Smith at 503-947-1119.
• The agreement will be executed and returned to you as soon as possible.

A copy of the NDA Between the state and Myers & Stauffer is available for your review.