MedicaidReimbursementMedium impact
Notification of Federal Upper Limit Changes
Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Apr 1, 2016
We identified it
Jun 20, 2026
Summary
Connecticut's Medicaid program will begin using Federal Upper Limits (FUL) from CMS to reimburse multiple source prescription drugs starting April 1, 2016. This replaces the state's previous reimbursement methodology and drugs under FUL will no longer be eligible for Connecticut's Maximum Allowable Cost (MAC) program modifications.
Action Required
By April 1, 2016: Pharmacy billing teams in Connecticut must update their systems to recognize that multiple source prescription drugs will be reimbursed using Federal Upper Limits from CMS rather than previous state methodology. Remove any billing modifications related to Connecticut's Maximum Allowable Cost (MAC) program for drugs covered under FUL. Monitor monthly FUL updates on Medicaid.gov that become effective on the first day of each month.