PDFWAC 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.
[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.]