Utah Medicaid Pharmacy Reimbursement
Utah Department of Health and Human Services’ Utah Medicaid Program has contracted with Myers and Stauffer LC, a national accounting firm, to provide and maintain the information necessary to assist the Utah Medicaid Program with its Utah Maximum Allowable Cost (UMAC) program. The primary goal of the State’s contract with Myers and Stauffer LC, is to develop and maintain a comprehensive reimbursement methodology that offers Utah Medicaid pharmacy providers accuracy, consistency, and transparency in the rate setting process while complying with the federal mandates. Utah Medicaid Program’s ingredient reimbursement utilizes the UMAC and the National Average Drug Acquisition Cost (NADAC), which is an actual acquisition cost reimbursement index calculated by CMS.
Utah’s UMAC rate is calculated by Myers and Stauffer through a comprehensive survey of Utah pharmacy providers. As Utah specific UMAC rates are developed and updated, the UMAC rates will be available on this website. Please check this website regularly for a link to the most accurate NADAC rates and changes in the current Utah UMAC lists.
If you have trouble opening or downloading the files from this website, please contact Myers and Stauffer LC at (800) 591-1183 and ask for the Utah pharmacy help desk.
Information and materials on this site may not be published or used except as provided under these terms and conditions, or as otherwise noted on this site, without written permission of the State of Utah, Utah’s Department of Health and Human Services, Utah’s Medicaid Program and/or Myers and Stauffer LC.
Important Contact Information
Help Desk Line: 800.591.1183
Click here for administrative log in.
Utah Cost of Dispensing Survey Information
The Utah Medicaid Program has contracted with Myers and Stauffer LC, a national accounting firm, to conduct a pharmacy cost of dispensing survey as part of the process to evaluate the costs associated with dispensing prescription medications to Utah Medicaid recipients. Surveys will be mailed on March 2, 2023 with a due date of April 13, 2023. Please call Myers and Stauffer at 800.374.6858 or email firstname.lastname@example.org if you have any questions pertaining to the cost of dispensing survey. Below are the initial notification letters and the Excel survey tools for single pharmacies or multiple locations.
Utah Maximum Allowable Cost (UMAC) Rate List and Archive
UMAC Rate Listings
If you have difficulty opening or downloading the files listed at right, please contact Myers and Stauffer’s pharmacy help desk at (800) 591-1183.
UMAC Rate Listings
Pharmacy Help Desk and Rate Review
Myers and Stauffer maintains a help desk for the UMAC rates. Please see the Communication Plan, rate review form, or on-line form links below to submit your questions to Myers and Stauffer. Providers may contact Myers and Stauffer directly at:
Toll-free phone: (800) 591-1183
Fax: (317) 571-8481
To see the current NADAC rate list, please visit the CMS pharmacy pricing page at:
https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing/index.html. If you have a question regarding a NADAC rate, please contact the NADAC Help Desk website or contact them directly at:
Toll-free: (855) 457-5264
Fax: (844) 880-0236
Please note that the NADAC help desk cannot address pharmacy inquiries for Utah specific claims reimbursement related questions or concerns. Information regarding the NADAC help desk can be found at the CMS Retail Price Survey website. https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing/index.html
If you have difficulty opening or downloading the files listed below, please contact Myers and Stauffer’s pharmacy help desk at (800) 591-1183.
Submit your UMAC rate review request online.
Below is the April 2020 provider stakeholder webinar overview of the UMAC program and the provider Q&A from the meeting.