The files below include the Georgia Maximum Allowable Cost (GMAC) and
Select Specialty Pharmacy Rates (SSPR) which identifies the maximum
reimbursement for each product. Products listed will be reimbursed at
the GMAC or SSPR unless the prescriber receives prior approval for the
brand name drug.
Including a product on the GMAC or SSPR list does not constitute automatic
coverage for all recipients. For instance, Niacin and Vitamin B with C are
covered only for patients with end stage renal disease.
For procedural questions, contact Catamaran Technical Assistance Help Desk at
NOTE: This list is for the Medicaid program and is not the preferred
drug list for the State Health Benefit Plan or the Board of Regents Health Plan
Please reverse and resubmit affected claims in order to be reimbursed at a
higher pricing level. Reprocessed claim adjustments can be seen in upcoming
remittance advices. For procedural questions, contact Catamaran Technical Assistance
Help Desk at (866) 525-5826.
Please share this information with appropriate staff. If you are the corporate
office of a chain pharmacy, please provide this information to each of your stores
located in Georgia. If you have additional questions or concerns regarding this notification,
please contact Pharmacy Services at (404) 656-4044.