State Pharmaceutical Assistance Programs ... - Medicaid

1 State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price* (last updated May 2021) Manufacturers should refer to the list below for the purposes of determining whether a SPAP is excluded from the Medicaid Best Price. State Program Name Arizona (2) Arizona Seriously Mentally Ill Program Arizona Crisis Program California (2) Genetically Handicapped Persons Program California Children's Services Connecticut (2) Connecticut Pharmaceutical Assistance Contract to the Elderly and Disabled(ConnPACE) General Assistance Program Non-Qualified Non Citizens Program Delaware (4) Chronic Renal Disease Program Delaware Prescription Assistance Program Delaware Cancer Treatment Program Illinois Illinois Cares Rx Basic Maine Maine Low Cost Drugs for the Elderly or Disabled (DEL) Program Maryland Pharmacy Assistance Program Maryland (4)

2 Maryland Kidney Disease Program Maryland Medicaid State -Only Program Maryland Breast and Cervical Cancer Diagnosis Treatment Program (BCCDTP) Minnesota (2) Minnesota Prescription Drug Program General Assistance Medical Care Program Missouri Missouri Rx Plan Montana Mental Health Services Plan Nevada (3) Disability Rx Program HAX Program Senior Rx Program Pharmaceutical Assistance to the Aged and Disabled (PAAD) New Jersey (4) Senior Gold Prescription Program Work First New Jersey General Assistance Program (WFNJ/GA) Medicare Part D Wraparound Program New York Elderly Pharmaceutical Insurance Coverage (EPIC) North Carolina (2) Senior Care Program NC HIV SPAP State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price* (last updated May 2021) Manufacturers should refer to the list below for the purposes of determining whether a SPAP is excluded from the Medicaid Best Price.

3 State Program Name Pharmaceutical Assistance Contract for the Elderly (PACE) Pennsylvania (4) General Assistance Program Chronic Renal Disease Program Special Pharmaceutical Benefits Program - Mental Health Component (SP2) Rhode Island Rhode Island Prescription Assistance for the Elderly (RIPAE) Texas (2) Kidney Health Care Program Healthy Texas Women Vermont VPharm SeniorCare (Above 200% FPL) Wisconsin (4) Chronic Renal and Cystic Fibrosis Program Chronic Disease Program Home Hemophilia Program Total: 20 States 43 Programs * The Medicaid statue allows manufacturers participating in the Medicaid Drug Rebate Program to exclude prices to State Pharmaceutical Assistance Programs (SPAPs) from their Medicaid Best Price calculations.

4 CMS has compiled a list of Programs that meet the criteria to be considered SPAPs. Please note that this list only includes states that submitted a description of their Programs to CMS for review based on the established criteria in CMS' Manufacturer Release #68 (April 1, 2005). The qualification of State -only Programs as SPAPs is based on the information provided by the State and may be subject to further review if changes occur within the program.