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The Walton Health Plan uses the fee-for-service pharmaceutical reimbursement approach known as the maximum allowable cos

Posted: Fri May 05, 2023 11:03 am
by answerhappygod
The Walton Health Plan uses the fee-for-service pharmaceutical reimbursement approach known as the maximum allowable cost (MAC) method. If Walton's MAC list specifies a cost of 8 cents per tablet for a particular drug but the participating pharmacy pays 10 cents per tablet for the drug, then Walton will be obligated to reimburse the pharmacy for:

A. 8 cents per tablet, but the pharmacy can bill the subscriber for the remaining 2 cents per tablet
B. 8 cents per tablet, and the pharmacy cannot bill the subscriber for the remaining 2 cents per tablet
C. 10 cents per tablet, but the pharmacy must refund the extra 2 cents per tablet to the subscriber
D. 10 cents per tablet, and the pharmacy is not required to refund the extra 2 cents per tablet to the subscriber