What is a State Maximum Allowable Cost (State MAC) rate schedule?
State Maximum Allowable Cost (State MAC) rate schedules are based on the premise that chemically equivalent drug products in the same strength and dosage available from multiple sources should be reimbursed similarly. State MAC rates are designed to maximize the cost-effectiveness of pharmacy services by setting reimbursement amounts for therapeutically equivalent drug products at the same price, based on the cost of the products. The Centers for Medicare and Medicaid Services (CMS) uses this same premise to establish federal upper limits (FULs) for drug products. State MAC rates are essentially the state Medicaid program version of CMS FULs.
