S.D. Admin. R. 67:16:14:06.02
Drugs covered under the state MAC list are limited to those drugs that are widely and consistently available to South Dakota pharmacies at a price that is less than the consolidated price. The department, in consultation with the contractor, shall determine which drugs to place on the state MAC list and shall establish the maximum allowable price for each drug contained on the list. The maximum allowable price for each drug is based on the cost at which the drug is available to South Dakota pharmacy providers. The department, in consultation with the contractor, shall review the state MAC list and the associated maximum allowable prices at least monthly.
The department, in consultation with the contractor, shall update the state MAC list when the department receives information from the contractor that the price for a specific drug has changed or a drug is now available or is no longer available to South Dakota pharmacies at a price less than the consolidated price. In addition, a pharmacist may request that the list be amended. To request an amendment to the list, the pharmacist must contact the Department of Social Services, Office of Medical Services. The pharmacist must specify the reason for the requested change. When considering the request, the department shall consult with the contractor to confirm the price change. When the department takes final action on the requested change, the department shall notify the pharmacist who made the request. The department shall notify participating providers of changes made to the list.
Payment for drugs located on the state MAC price list is limited to the amount specified on the list unless subdivision 67:16:14:06(1) or (2) is lower. The state MAC list is on the departments pharmacy website.
S.D. Admin. R. 67:16:14:06.02
General Authority: SDCL 28-6-1.
Law Implemented: SDCL 28-6-1.