Arkansas Medicaid pharmacy reimbursement
An audit of generic-drug reimbursement in Arkansas Medicaid, using the program's own federal reporting (Arkansas Medicaid fee-for-service vs PASSE managed care (provider-led plans and their PBMs)). Findings only — every number traces to a public dataset and a published script, and the reader is welcome to check both.
The short version
Over the latest four quarters (through 2026 Q1), Arkansas's managed-care filings show $6.99 per generic prescription above national-average acquisition cost — consistent with the dispensing fee being included in the reported totals — versus $9.60 under fee-for-service. The drug-level sections below show where reimbursement lands relative to acquisition cost regardless.
Background
Arkansas is where the legal fight over PBM payment floors was won: its Act 900 of 2015, requiring PBMs to reimburse pharmacies at no less than invoice cost, was upheld unanimously by the U.S. Supreme Court in Rutledge v. PCMA (2020) — the decision that opened the door to state PBM regulation nationwide. Most Arkansas Medicaid pharmacy runs through fee-for-service at NADAC plus a $10.50 generic dispensing fee; the managed-care rows are the PASSE program, provider-led plans covering members with complex behavioral and developmental needs since 2019.
Every state reports its Medicaid drug utilization to CMS, which publishes it as the State Drug Utilization Data (SDUD) — per drug, per quarter, fee-for-service and managed care separated. This report compares those reported payments against NADAC (CMS's national survey of pharmacy invoice prices) for every generic drug that can be matched.
Reported payment above ingredient cost, per generic prescription
ⓘ How this was built
- CMS State Drug Utilization Data (Arkansas rows, FFSU vs MCOU)
- CMS NADAC quarterly per-NDC averages
- FDA NDC Directory (ANDA = generic)
For each quarter and payment system: (total amount reimbursed − units × quarterly NADAC) ÷ prescriptions, summed over every generic NDC with a NADAC price that quarter. Neither side of SDUD itemizes the dispensing fee — this residual is all that is measurable. Suppressed cells (fewer than 11 claims) are absent from the source data; brands are excluded because rebates make their gross prices uncomparable.
Pipeline and calculations built by Claude (Fable 5) from the public datasets above. Educational only — verify against primary sources before acting.
One limit stated plainly: no public dataset itemizes the fee on either side. The chart shows the reported residual above national-average ingredient cost — all that is measurable. A residual near the published fee is consistent with fee-included reporting; a residual near zero is consistent with ingredient-only reporting.
Methodology
Sources. CMS State Drug Utilization Data, Arkansas rows at full grain (NDC × quarter × utilization type), from data.medicaid.gov; CMS NADAC weekly files and monthly archives, same portal; FDA NDC Directory application numbers (ANDA = generic) via openFDA; the state's professional dispensing fee of $10.50 from Arkansas Medicaid reimbursement methodology (NADAC + $10.50 generics).
Computation. Quarterly NADAC per NDC = the latest monthly average observation at or before the quarter's end (look-back capped at 6 months). Ingredient margin = total amount reimbursed − units × quarterly NADAC; per-prescription figures divide by prescription count. All sums are over generic NDCs (ANDA approvals) with a NADAC price in the quarter.
Exclusions. Brand drugs (statutory rebates make their gross prices incomparable); SDUD cells suppressed by CMS (fewer than 11 claims); NDCs without a NADAC price that quarter.
Reproduce it. Every number on this page is emitted by one script, public in our repository: drugdashboards/reports/state_report.py. Generated 2026-08-30.
A DrugDashboards report · the 50-state fee survey · site-wide methodology · informational only — not legal, clinical, or purchasing advice.