Frequently Asked Questions

 
Why might Colorado Medicaid request information about my pharmacy’s drug purchases?
Why should I send information about my pharmacy’s drug purchases to Colorado Medicaid, if requested to do so?
What are the acceptable methods to transmit my drug purchase information?
What will Colorado Medicaid do with drug purchase information it receives from me?
Why might my pharmacy be selected to provide drug purchase information?
How often might I be asked to provide drug purchase information?
For what time period would my drug purchase information be requested?
How will the AAC rates be updated? How do I report concerns about product prices or product availability?
What if my cost is higher than the AAC reimbursement rate?
How often will the AAC rate schedule on the Myers and Stauffer Colorado Pharmacy Web site be updated?
Whom may I contact with questions regarding this initiative?
Contact Myers and Stauffer by Telephone, Fax, Mail, or email
Contact Myers and Stauffer Online
I didn’t respond to the claims volume survey so Medicaid doesn’t have my claims volume, what’s my dispensing fee?
Can my dispensing fee rate be adjusted if my claims volume changes?
Why might Colorado Medicaid request information about my pharmacy’s drug purchases?
In order to maintain an AAC program with reimbursement that reflects current pharmaceutical market conditions, the AAC rates are based on the actual acquisition costs of Medicaid pharmacy providers. The calculated rates are designed to reimburse ingredient costs at a rate that is reflective of the average costs that Colorado pharmacy providers are experiencing.
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Why should I send information about my pharmacy’s drug purchases to Colorado Medicaid, if requested to do so?
The AAC rates are based on Medicaid pharmacy providers’ actual experiences purchasing selected drug products. Providers who receive requests for drug purchase information are strongly encouraged by the State to provide the requested information to ensure that the established AAC rates fully consider providers’ cost experience in the marketplace.
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What are the acceptable methods to transmit my drug purchase information?
For drug purchases made during the identified time period requested by CO DHCPF, providers can simply retrieve the invoices reflecting their purchases, photocopy the records, and then mail the copies to Myers and Stauffer. A provider can also provide this data via email in an electronic format. Electronic files can be accepted in Excel, pdf and text file format. A provider may request that its wholesaler electronically send this information to Myers and Stauffer. Informational letters that accompany the survey request will have more detailed submission information.
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What will Colorado Medicaid do with drug purchase information it receives from me?
CO DHCPF will use drug purchase information submitted by pharmacies for the purpose of establishing, evaluating, maintaining, and updating AAC rates. CO DHCPF has contracted with the firm of Myers and Stauffer to assist in developing and maintaining the AAC program. Pharmacies are encouraged to submit copies of purchase information, rather than originals as information submitted will not be returned.
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Why might my pharmacy be selected to provide drug purchase information?
All pharmacy providers enrolled in the Colorado Medicaid program are eligible for random selection to provide drug purchase information.
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How often might I be asked to provide drug purchase information?
All pharmacy providers enrolled in the Colorado Medicaid program are eligible for selection to provide drug purchase information. A random sample of pharmacies are selected to participate in acquisition cost studies on a monthly basis. We anticipate a frequency of no more than once per year.
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For what time period would my drug purchase information be requested?
All pharmacy providers enrolled in the Colorado Medicaid program are eligible for selection to provide drug purchase information. When a request is received for drug purchase information, the time frame of the data requested will be for the most recent 30 day period. If that drug purchase information for the most recent 30 day period is not readily available, then the next most recent 30 day period will be acceptable.
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How will the AAC rates be updated? How do I report concerns about product prices or product availability?
Baseline AAC rates will be calculated monthly based on invoice costs submitted by Colorado Medicaid pharmacies. To respond to changes in the marketplace, AAC rates will also be reviewed weekly for published pricing changes and daily when inquiries are received through the pharmacy help desk. When contacting the pharmacy help desk, you will be asked to provide information regarding your request. Information should include, but not be limited to drug purchase summaries, invoices, remittance advices, and other such documentation. In the absence of sufficient information to assess concerns about AAC rates or other aspects of the AAC program, provider requests cannot be fully considered. Providers initiating requests for review of AAC rates or other issues may be contacted to request supporting documentation or other information.
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What if my cost is higher than the AAC reimbursement rate?
AACs are based on the average acquisition cost of pharmacy providers and therefore may sometimes be below the costs experienced by individual providers. Adjustments will be made to the AAC rate when the overall average has increased. If your acquisition costs have increased, you may contact Myers and Stauffer’s Colorado pharmacy help desk at 800-591-1183 to report your concerns and request a rate review. AAC rates will be adjusted when the overall average cost of a drug has increased. AAC rates will not be eligible for adjustment due to an individual provider’s inability to purchase the drug below the AAC if the overall average has not changed.
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How often will the AAC rate schedule on the Myers and Stauffer Colorado Pharmacy Web site be updated?
The AAC rate listing will be updated weekly.
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Whom may I contact with questions regarding this initiative?
We welcome provider's questions, comments, and input regarding the AAC program. To share general comments or to request information regarding the AAC rates, you may contact the Myers and Stauffer Pharmacy Unit.
Providers are encouraged to contact the Myers and Stauffer Pharmacy Unit to discuss:
    ·    Changes in acquisition cost of a drug
    ·    Changes in product availability
    ·    Questions regarding AAC rates
    ·    Questions concerning drugs on the AAC rate list
    ·    How to obtain a copy of the AAC rate list
    ·    Other questions, comments, or concerns
Please contact the Colorado Department of Healthcare Policy & Financing for policy questions.
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Contact Myers and Stauffer by Telephone, Fax, Mail, or email
Parties who wish to comment or discuss questions, comments, or concerns about the AAC program may contact Myers and Stauffer weekdays between 8:00 A.M. and 5:00 P.M. (Central Time) as follows:
Myers and Stauffer LC Pharmacy Unit
9265 Counselors Row, Suite 100
Indianapolis, Indiana 46240
Phone:  800-591-1183
Fax:  317-571-8481
Email:  copharmacy@mslc.com
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Contact Myers and Stauffer Online?
Comments or questions may be forwarded to Myers and Stauffer via the Internet at any time by visiting http://www.mslc.com/Colorado/. This Internet site has been developed exclusively to support the Colorado Medicaid AAC program. On the site, providers will find the AAC rate schedule and updates, news and information, and online forms to send questions and comments to Myers and Stauffer.
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I didn’t respond to the claims volume survey so Medicaid doesn’t have my claims volume, what’s my dispensing fee?
Providers who didn’t respond to the Colorado Medicaid Claims Volume survey will default to the lowest dispensing fee tier.
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Can my dispensing fee rate be adjusted if my claims volume changes?
Colorado Medicaid will request claims volume numbers from providers annually. Dispensing fees set at those numbers will remain until the next year’s survey of claim’s volume.
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“I can put them in a room with just about anybody and they can make it work with folks with just a high school education level all the way through PhD’s. I can put these CPAs in a room with any of them and they’ll make it work.”
— Current client, State Medicaid Director