42 C.F.R. §447.518 - State plan requirements, findings, and assurances

Cite as42 C.F.R. §447.518
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5 cases
  • State v. Abbott Labs., 2010AP232–AC.
    • United States
    • United States State Supreme Court of Wisconsin
    • June 22, 2012
    ...regulations compel state Medicaid agencies to devise procedures for reimbursing pharmacists who dispense drugs to Medicaid recipients. 42 C.F.R. § 447.518. Under the federal guidelines, the reimbursements may not exceed the lesser of 1) the estimated acquisition cost [816 N.W.2d 151](“EAC”)......
  • United States ex rel. Schutte v. SuperValu Inc., 20-2241
    • United States
    • United States Courts of Appeals. United States Court of Appeals (7th Circuit)
    • August 12, 2021
    ...for prescription drugs," and the drug reimbursement methodology must comport with federal requirements for Medicaid expenditures. 42 C.F.R. § 447.518(a) – (b). Relevant here, federal regulations limit the pharmacy reimbursement for certain prescription drugs to the lower of either "[Actual ......
  • La. Dep't of Health v. U.S. Dep't of Health & Human Servs., 20-60213
    • United States
    • United States Courts of Appeals. United States Court of Appeals (5th Circuit)
    • April 5, 2021
    ...provide that the state must "maintain and make available to [CMS], upon request, documentary evidence to support the findings." 42 C.F.R. § 447.518(c). The "documentary evidence must include data, mathematical and statistical computations, comparisons, and any other pertinent records." Id. ......
  • United States ex rel. Strauser v. Stephen L. Lafrance Holdings, Inc., Case No. 18-CV-673-GKF-FHM
    • United States
    • United States District Courts. 10th Circuit. Northern District of Oklahoma
    • March 7, 2019
    ...and all state plans must periodically determine that there are in accordance with § 447.512. Schutte, 218 F. Supp. 3d at 773 (citing 42 C.F.R. § 447.518(B)(1)(ii)); see also [FAC ¶ 44]. Relator alleges that the Medicaid rules of each of the seven states at issue prohibit a pharmacy from bil......
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