The Kentucky Department of Workers' Claims has proposed changes to its pharmacy fee schedule, including a new method of determining the lowest possible reimbursement amount.
In a notice posted on its website, the department said the maximum allowable reimbursement for prescription drugs would be the lesser of:
The provider's usual and customary charges.
The amount the insurer has agreed to pay under contract with a pharmacy benefits manager.
60% of the average wholesale price for generic drugs.
85% of the AWP for brand-name drugs.
The AWP would be determined by the price ...
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