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  Sunday, May 29, 2016
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(click to hide) Alert Message posted 5/25/2016
Holiday Call Center Closure
In observance of the Memorial Day holiday, the Georgia Medicaid Call Centers will be closed on Monday, May 30, 2016. The call centers will resume normal operating hours, starting at 7AM Eastern Time, on Tuesday, May 31, 2016.
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Pricing List

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 (866) 525-5826.

 

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 pharmacy programs.

Obtaining the New Price for Previously Paid Claims

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.

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Pricing List (more than 150 available) List
 
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Pricing List (more than 150 available)

 
 TitleFile TypeCategorySize (KB)Release Date 
GMAC Increases - Effective 5/12/2016PDFGMAC INCREASES7.8005/17/2016 
GMAC Suspensions - Effective 5/12/16PDFGMAC SUSPENSIONS86.6005/17/2016 
GMAC Decreases - Effective 6.1.16PDFGMAC DECREASES10.7005/13/2016 
GMAC Additions - Effective 4/5/2016PDFGMAC ADDITIONS172.7004/12/2016 
GMAC Decreases - Effective 5/5/2016PDFGMAC DECREASES10.3004/12/2016 
GMAC Increases - Effective 4/11/2016PDFGMAC INCREASES7.4004/12/2016 
GMAC Suspensions - Effective 4/5/2016PDFGMAC SUSPENSIONS87.4004/12/2016 
GMAC Price Increases Effective 2.10.16PDFGMAC INCREASES7.5003/17/2016 
GMAC Price Increases Effective 3.15.16PDFGMAC INCREASES7.4003/17/2016 
GMAC Suspensions - Effective 2/18/2016PDFGMAC SUSPENSIONS87.6003/17/2016 
GMAC Additions - Effective 3/9/2016PDFGMAC ADDITIONS170.3003/11/2016 
GMAC List - 2Q2016 (Effective 4.1.16)PDFGMAC LIST652.8003/11/2016 
GMAC Suspensions - Effective 3/9/2016PDFGMAC SUSPENSIONS87.2003/11/2016 
GMAC Decreases - Effective 4.1.2016PDFGMAC DECREASES10.7003/02/2016 
Select Specialty Pharmacy Rates - revised 2.16.2016PDFSSPR1064.4002/17/2016 
GMAC Additions - Effective 01.25.2016PDFGMAC ADDITIONS167.3001/26/2016 
GMAC Decreases - Effective 1.25.2016PDFGMAC DECREASES7.9001/26/2016 
Select Specialty Pharmacy Rates - revised 1.11.2016PDFSSPR1049.3001/12/2016 
Select Specialty Pharmacy Rates - revised 12.23.15PDFSSPR1049.9001/01/2016 
GMAC List - 1Q2016 (Effective 1.1.16)PDFGMAC LIST634.4012/17/2015 
GMAC Additions - Effective 11/25/15PDFGMAC ADDITIONS17512/01/2015 
GMAC Decreases - Effective 11 25 15PDFGMAC DECREASES98.4012/01/2015 
GMAC Suspensions - Effective 11/25/15PDFGMAC SUSPENSIONS89.8012/01/2015 
GMAC Additions - Effective 10/30/15PDFGMAC ADDITIONS12.8011/02/2015 
GMAC Additions - Effective 11/2/15PDFGMAC ADDITIONS167.6011/02/2015 
GMAC Increases - Effective 10/1/15PDFGMAC INCREASES7.6010/26/2015 
GMAC Increases - Effective 8/1/15PDFGMAC INCREASES7.6010/26/2015 
Select Specialty Pharmacy Rates - revised 10.11.15PDFSSPR1046.3010/13/2015 
GMAC Increases - Effective 7/1/15PDFGMAC INCREASES10.2009/28/2015 
GMAC Increases - Effective 9/10/15PDFGMAC INCREASES7.8009/28/2015 
GMAC Suspensions - Effective 09/10/15PDFGMAC SUSPENSIONS7.3009/28/2015 
Select Specialty Pharmacy Rates - revised 9.16.15PDFSSPR1029.7009/18/2015 
GMAC List - 4Q2015 (Effective 10.15.15)PDFGMAC LIST638.6009/16/2015 
GMAC Suspensions - Effective 08.20.15PDFGMAC SUSPENSIONS7.3008/20/2015 
Select Specialty Pharmacy Rates - revised 08.13.15PDFSSPR1029.1008/17/2015 
GMAC Additions - Effective 07/24/2015PDFGMAC ADDITIONS10.5007/27/2015 
GMAC List - 3Q2015 (Effective 07.01.15)PDFGMAC LIST640.2006/23/2015 
Select Specialty Pharmacy Rates - revised 06.09.15PDFSSPR1036.8006/10/2015 
GMAC Increases - Effective 02/18/2015PDFGMAC INCREASES7.7006/09/2015 
GMAC Increases - Effective 04/01/15PDFGMAC INCREASES13.3006/09/2015 
GMAC Suspensions - Effective 04.01.15PDFGMAC SUSPENSIONS7.1006/09/2015 
Select Specialty Pharmacy Rates - revised 05.18.15PDFSSPR1490.7005/18/2015 
Select Specialty Pharmacy Rates revised 04.15.15PDFSSPR100604/15/2015 
Select Specialty Pharmacy Rates - revised 03.26.15PDFSSPR1034.9004/08/2015 
GMAC List - 2Q2015 (Effective 04.01.15)PDFGMAC LIST654.1003/24/2015 
Select Specialty Pharmacy Rates - revised 03.16.15PDFSSPR1009.5003/23/2015 
GMAC Suspensions - Effective 03/09/2015PDFGMAC SUSPENSIONS7.7003/09/2015 
Select Specialty Pharmacy Rates - revised 2.24.15PDFSSPR1009.4003/03/2015 
GMAC Increases - Effective 2.23.2015PDFGMAC INCREASES8.2002/24/2015 
GMAC Suspensions - Effective 2.18.2015PDFGMAC SUSPENSIONS7.3002/24/2015 
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