Federal Upper Limits

The Affordable Care Act revised the Federal Upper Limit (FUL) provisions to require that the Secretary calculate the FULs as no less than 175 percent of the weighted average (determined on the basis of utilization) of the most recently reported monthly average manufacturer prices (AMP) for pharmaceutically and therapeutically equivalent multiple source drug products that are available for purchase by retail community pharmacies on a nationwide basis. In accordance with these provisions, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-2345-P) that FULs would be calculated as 175 percent of the weighted average of AMPs.

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