La. Admin. Code tit. 50 § XXIX-961
Actual Acquisition Cost-the covered entitys net payment made to purchase a drug product.
Contract Pharmacy-a pharmacy under contract with a covered entity that provides services to the covered entitys patients, including the service of dispensing the covered entitys 340B drugs, in accordance with Health Resources and Services Administration (HRSA) guidelines (75 FR 10272, March 5, 2010). Contract pharmacies are not allowed to bill Medicaid for pharmacy claims.
Covered Entity-a provider or program that meets the eligibility criteria for participating in the 340B Program as set forth in section 340B(a)(4) of the Public Health Service Act. Covered entities include eligible disproportionate share hospitals that are owned by, or under contract with, state or local government, community health centers, migrant health centers, health centers for public housing, health centers for the homeless, AIDS drug assistance programs and other AIDS clinics and programs, black lung clinics, hemophilia treatment centers, native Hawaiian health centers, urban Indian clinics/638 tribal centers, 340s school-based programs, Title X family planning clinics, sexually-transmitted disease clinics and tuberculosis clinics.
Dispensing Fee-Repealed.
Estimated Acquisition Cost (EAC)-the national average drug acquisition cost (NADAC) of the drug dispensed. If there is not a NADAC available, the EAC is equal to the wholesale acquisition cost, as reported in the drug pricing compendia utilized by the departments fiscal intermediary.
Medicaid Carve-Out- a billing mechanism available to covered entities that implements the 340B requirement protecting manufacturers from giving a 340B discount and paying a Medicaid rebate on the same drug. If a covered entity elects to implement the Medicaid carve-out option, the covered entity only purchases through the 340B Program covered drugs dispensed to non-Medicaid patients; drugs dispensed to Medicaid patients are purchased outside the 340B Program.
Patient- an individual eligible to receive 340B-discounted drugs from a covered entity by virtue of being the covered entity's patient as defined in HRSA's 1996 patient definition guideline (61 FR 55156, October 24, 1996).
Professional Dispensing Fee-the fee paid by Medicaid for the professional services provided by a pharmacist when dispensing a prescription. Per legislative mandate, the $0.10 provider fee assessed for each prescription filled in the state of Louisiana will be paid separately.
Wholesale Acquisition Cost (WAC)-the manufacturers published catalog price for a drug product to wholesalers as reported to Medicaid by one or more national compendia on a weekly basis.
La. Admin. Code tit. 50, § XXIX-961