Use cost‑based survey data to support fee changes (CMS guidance)

CMS requires that proposed changes to professional dispensing fees be supported by adequate cost-based data (for example, a state or national survey); market-based research or third‑party payment data alone do not qualify as supporting data.

Provide supporting documentation for adjustments and shipping offsets

Pharmacies that received Medicaid shipping reimbursement had annualized shipping reimbursements offset against their calculated dispensing cost; a random sample of 21 pharmacies were asked to provide supporting documentation and all complied.

Complete and return the cost survey by the deadline

Complete and return the Alaska Medicaid Pharmacy Cost of Dispensing Survey by the stated return date; contact Myers and Stauffer for the electronic template or assistance via the provided phone/email.

• Return completed survey by April 9, 2024 (deadline stated on the form).
• Request electronic Excel version from disp_survey@mslc.com or 1-800-374-6858.

Declare exemption if new or changed ownership (<6 months)

If the pharmacy was open less than six months during the reporting period or experienced a change in ownership resulting in less than six months in business, the pharmacy may check the Declaration of Exemption and is not required to complete the remainder of the survey.

• Enter the date the pharmacy opened or the date ownership changed on the form.
• Contact Myers and Stauffer at 1-800-374-6858 or disp_survey@mslc.com with questions.

Report product breakdown and reconcile totals to Section IA

Report the number of prescriptions and dollar sales by specialty and non‑specialty categories and ensure those totals reconcile to Section IA prescriptions and pharmacy department sales; report percent dispensed to health‑care professional/clinic for administration for each category.

• Provide counts and dollar sales for each specialty product category (infusion, TPN, clotting factors, prefilled, orals, topicals, injectables, compounded, enteral, other).
• Ensure product totals reconcile to Section IA prescriptions and sales.

Describe specialty services and programs in narrative section

Provide a narrative description of specialty products and related services, including patient monitoring, compliance programs, case/disease management, specialized equipment, and REMS‑related activities.

• Describe monitoring, compliance, case management, specialized storage/equipment and REMS activities as applicable.

Mandatory participation — non‑response may trigger fee reduction

All Alaska Medicaid enrolled pharmacies supplied a survey must participate; failure to participate may result in reducing the provider's dispensing fee to $3.45 or other sanctions under state regulation.

• Participation is mandatory per 7 AAC 105.400(27) and related regulations.
• Non‑participation may trigger fee reduction to $3.45 per 7 AAC 145.410(c).

Independent pharmacies: submit survey and optional financials/tax return

Complete the enclosed survey for each single‑store pharmacy; you may submit store financial statements or a federal tax return if you elect to have Myers and Stauffer complete specified overhead and reconciliation sections; retain a copy of the completed survey for your records.

• If submitting financials/tax return for a single store, Myers and Stauffer will complete Section IIB and Section III for you.
• Retain a copy of the completed survey.

Chains: submit a completed survey for each store (per‑store reporting)

Submit a completed survey for each store/location participating in Alaska Medicaid; chains must submit per‑store data and may use the Excel template provided.

• Each store must submit its own survey form and supporting information.
• Chains are encouraged to use the electronic Excel template.

I/T/U pharmacies: submit per‑location surveys and allocate org costs

I/T/U organizations must submit a survey for each pharmacy location; guidance is provided for allocating organization‑level costs to individual pharmacy operations.

• Submit per‑location survey data even if part of an I/T/U organization.
• Use the provided guidance to allocate organization‑level costs to each pharmacy.

Submit survey electronically using the Excel template (email or Secure FTP)

Electronic submission is encouraged via the Excel template; obtain the template from disp_survey@mslc.com and submit completed electronic surveys by email or via Secure FTP when provided.

• Request the Excel spreadsheet from disp_survey@mslc.com or call 1-800-374-6858.
• Email completed Excel survey files to disp_survey@mslc.com or use Secure FTP if arranged.

Paper submission: mail each store's survey using the Business Reply Envelope

Paper submission is allowed—send completed paper forms (one per store) to Myers and Stauffer LC at the Kansas City Business Reply address; postage is prepaid.

• Mail to: Myers and Stauffer LC, Attn: Alaska Medicaid Pharmacy Cost of Dispensing Survey, 700 W. 47th Street, Suite 1100, Kansas City, MO 64112.
• Use the enclosed Business Reply Envelope; postage will be paid by Myers and Stauffer LC.

Survey validation — selected providers will be asked for follow‑up documentation

All submitted surveys will be reviewed and validated; a random sample will be selected for further validation and providers will be notified and asked to provide supporting documentation if selected.

• Myers and Stauffer will notify pharmacies selected for additional validation and specify required documentation.
• Submitted materials remain strictly confidential.

Mandatory participation and informational webinars; deadlines and extensions

All pharmacies enrolled in Alaska Medicaid are required to participate in the survey; informational webinars are scheduled and surveys must be returned by April 9, 2024 (acceptance extended to April 16, 2024 for representation).

• Informational meetings/webinars available (dates include March 14 and March 19, 2024).
• Original due date April 9, 2024; DOH instructed Myers and Stauffer to accept surveys through April 16, 2024.

If selected for desk review, submit financials, prescription reports, store diagram, and work papers within 10 days

Selected pharmacies must submit supplemental desk review documentation within ten days; required items include a store‑specific financial statement or single‑store federal tax return (with schedules), prescription reports, store diagram/blueprint for square footage, and any other work papers used to complete the survey.

• Provide store‑specific financial statements or single‑store tax return with schedules.
• Provide prescription dispensing reports and store diagrams/blueprints.
• Submit any other work papers relied upon to complete the survey.
• Documentation must be submitted within ten days of the request (can be emailed to disp_survey@mslc.com).

Non‑response penalty: dispensing fee may be reduced to $3.45

Pharmacies that do not meet the initial submission deadline may have their professional dispensing fee reduced to $3.45 and may be subject to sanctions under Alaska regulations until a completed survey is submitted.

• Fee reduction to $3.45 applies until a completed survey is submitted.
• Additional sanctions may be imposed under 7 AAC 105.400–105.490.

Inflate reported overhead and labor costs to 12/31/2023 using BLS indices

Apply inflation adjustment factors (based on the BLS Employment Cost Index with linear interpolation for non‑quarter months) to reported overhead and labor costs to normalize costs to December 31, 2023 (midpoint for fiscal period ending 6/30/2024).

• Inflation factors adjust each pharmacy's reported costs from its fiscal year midpoint to 12/31/2023.
• Quarterly indices from the BLS Employment Cost Index were applied and non‑quarter months interpolated linearly.

Survey results include per‑pharmacy dispensing cost values and statistical summaries

Survey results present per‑pharmacy original and revised dispensing cost per prescription, with reported means, medians, weighted measures, and aggregate cost measurements used to inform reimbursement options.

• Results include unweighted means, weighted means (by total and Medicaid volume), and medians.
• Exhibit tables list original and revised per‑pharmacy dispensing cost values and aggregate statistics.

Verify your listing on the participating pharmacies roster

A list of pharmacies participating in the Alaska Cost of Dispensing Survey is provided; pharmacies named in the participant list are considered participating and should submit individual surveys as applicable.

• Participant roster includes chain and independent pharmacies, hospital and tribal providers as listed in the document.
• Verify your store(s) on the attached participant list and notify Myers and Stauffer of inaccuracies.