Under the final rule, HCFA established an aggregate reimbursement limit for drugs under Medicaid.
The final rule was published in the July 31 Federal Register ("The Pink Sheet" August 3, 1987, p. On the other hand, they have to be high enough to attract sufficient qualified providers so that Medicaid recipients will receive the same medical care as other citizens." The court suit, prepared by NACDS outside lawyer Nancy Buc (Weil, Gotshal & Manges, D.C.), was filed two days prior to the Oct. On the one hand, reimbursement levels ought not to be so high as to be uneconomical for the government and the taxpayers. "In establishing reimbursement for Medicaid providers, Congress sought to balance two competing purposes. NACDS said the MAC reg revision should be declared invalid because "the preamble to the final rule does not consider all statutory objectives, including whether reimbursement under the final rule will allow efficient providers to make a reasonable profit." The association maintained that the new MAC regulation only partly satisfies Congress' intent under Medicaid. HCFA's MAC STATUTORY RESPONSIBILITY TO ALLOW REASONABLE PROFIT for participating providers was not considered by the administration in revising the MAC regs, NACDS maintained in a suit filed Oct.
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