National Average Drug Acquisition cost Information

On April 1, 2016 the Kansas Medicaid program (KanCare) instituted a new pricing methodology for the managed-care organization (MCO) plans. Under this model, reimbursement of pharmacy claims are computed using the National Average Drug Acquisition Cost (NADAC) survey compiled by the actuarial firm Myers and Stauffer. Myers and Stauffer is the organization that should be sent all pricing appeals. This can be done by calling their toll-free help desk: 855-457-5264 or by email at info@mslcrps.com.

Surveys are sent to random pharmacies on a regular basis by Myers and Stauffer. Please be sure to complete any survey you may receive! The surveys are used to compute NADAC pricing for all pharmacies. The results are available to the public and uploaded weekly on the Medicaid website.

Kansas Medicaid Pharmacy Prior Authorization Form

Kansas Medicaid (FFS & MCO) Pharmaceutical Program

Effective July 15, 2016, certain maintenance medications for long-term conditions will require 90-day fills for patients who received a supply of at least 90 days of the medication over the previous 365 days.

SUNFLOWER HEALTH PLAN

• Website
• 90-day exemption form

AETNA

• Website

UNITED HEALTHCARE

• Website
• 90-day exemption form