MedicaidCoverageMedium impact
Discount Program, Copay Changes and Revised Calculation of Estimated Acquisition Cost
Maryland Medicaid·MD · Pharmacy·Pharmacy
Effective date
Jul 1, 2003
We identified it
Jun 20, 2026
Summary
Maryland launches a new Pharmacy Discount Program for Medicare recipients effective July 1, 2003, with recipients paying 65% copayment and pharmacies receiving 35% reimbursement. Additionally, MCO and REM recipients are no longer exempt from pharmacy copayments, and the pharmacy reimbursement calculation method is revised to use AWP-11% or WAC+9% (whichever is lower).
Action Required
By July 1, 2003: Pharmacy staff must update billing procedures to process new Maryland Pharmacy Discount Program (MPDP) cards through Point-of-Sale system, collect 65% copayment plus optional $1 administrative fee from MPDP enrollees, and implement new copayment collection for MCO and REM recipients. Update pharmacy system to use revised Estimated Acquisition Cost calculation (AWP-11% or WAC+9%, whichever is lower). Refer patients to www.dhmh.state.md.us/mma/ for medication cost estimates.