Douglas A. Ducey, Governor
Thomas J. Betlach, Director

October 5, 2015

Dear Pharmaceutical Manufacturer:

Arizona’s Medicaid Program, the Arizona Health Care Cost Containment System (AHCCCS), has contracted with Magellan Medicaid Administration, Inc. to secure supplemental rebates for preferred agents on the State’s Minimum Required Prescription Drug List (MRPDL) Program.  AHCCCS refers to its Preferred Drug List as the Minimum required Prescription Drug List because this PDL is both used by the State agency for Fee-For-Service dispensing and because the State’s managed care contracts require the contracted health plans to also use the MRPDL.  The intent of AHCCCS is to accrue rebates on both Fee-For-Service and Managed Care utilization for preferred agents under the MRPDL drug list model which is managed by the AHCCCS for covered outpatient drugs dispensed to persons eligible in Arizona for Medicaid, the Children’s Health Insurance Program and to persons with Serious Mental Illness, as defined in A.R.S. 36-550, who qualify for state funded care under A.R.S. 36-3408.  The AHCCCS supplemental rebate agreement, drafted with the express purpose of establishing a single MRPDL and described further in section 2.1 of the ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM SUPPLEMENTAL DRUG-REBATE AGREEMENT (SRA), was approved by CMS on May 28, 2015;

2.1 It is the intent of this Agreement that the State will receive Supplemental Rebates, in addition to the rebates received under Manufacturer’s CMS Agreement, pursuant to Section 1927 of the Social Security Act (42 U.S.C. §1396r-8), for the Manufacturer's Supplemental Covered Product(s) quarterly utilization in the Arizona Medicaid Program, including all Fee-For-Service and Managed Care beneficiaries, in which there is Medicaid federal financial participation.  The parties also intend for this Agreement to meet the requirements of federal law at Section 1927 of the Social Security Act (42 U.S.C. §1396r-8).

At  this  time,  supplemental  rebate  offers  are  requested  for  the  following  products  and  therapeutic categories which will be reviewed at the Pharmacy and Therapeutics Committee meeting on November
17, 2015

•           Epinephrine, Self Injected
•           Inhaled Antibiotics and Related Agents
•           Growth Hormone
•           Cytokine and CAM Antagonist

Supplemental rebate offers may be requested for additional products and/or other therapeutic categories in the future.

Please note the following deadlines:

Final supplemental rebate offers must be submitted to Provider Synergies LLC, an affiliate of Magellan Medicaid Administration, Inc. through the Secure FTP site found at https://secureftp.providersynergies.com/, by close of business on Tuesday, October 27th, 2015. Supplemental rebates will begin to accrue on January 1, 2016 and end December 31, 2016 for those drugs selected as preferred.

801 East Jefferson, Phoenix, AZ 85034 • PO Box 25520, Phoenix, AZ 85002 • 602-417-4000 • www.azahcccs.gov

We hope that you will take this opportunity to participate in a program that seeks to retain access to quality pharmaceuticals for Arizona’s most vulnerable citizens.

Sincerely,

Thomas J. Betlach
Director