Wash. Admin. Code § 182-530-8050

Current through Register Vol. 24-23, December 1, 2024
Section 182-530-8050 - Reimbursement - Federal upper limit (FUL)
(1) The medicaid agency adopts the federal upper limit (FUL) set by the Centers for Medicare and Medicaid Services (CMS).
(2) The agency's maximum payment for multiple-source drugs for which CMS has set FULs will not exceed, in the aggregate, the prescribed upper limits plus the dispensing fees set by the agency.
(3) Except as provided in WAC 182-530-7300, the agency uses the FUL as the agency's reimbursement rate for the drug when the FUL price is the lowest of the rates calculated under the methods listed in WAC 182-530-7000.

Wash. Admin. Code § 182-530-8050

Amended by WSR 16-01-046, Filed 12/9/2015, effective 1/9/2016

11-14-075, recodified as §182-530-8050, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.04.050, 74.08.090, 74.09.530, and 74.09.700. 07-20-049, § 388-530-8050, filed 9/26/07, effective 11/1/07.