STATE MAC PRICING INITIATIVES

Kansas:
The Kansas Department of Health and Environment requires in its Managed Care for Medicaid and CHIP Program (KanCare) contract with Health Insurers that:       

•         The insurer or its PBM will each year provide pharmacies the basis of methodology and   
  

        sources used to determine MAC pricing; Update MAC pricing information regularly;

•         Make MAC pricing information available on the KanCare website; and

•         Provide a reasonable administrative appeals procedure for a pharmacy provider to a       

        contested listed MAC rate.