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.
[Statutory Authority: RCW
41.05.021 and
41.05.160. WSR 16-01-046, § 182-530-8050, filed 12/9/15, effective 1/9/16. WSR 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. WSR 07-20-049, § 388-530-8050, filed 9/26/07, effective 11/1/07.]