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The Walton Health Plan uses the fee-for-service pharmaceutical reimbursement approach known as the maximum allowable...

The Walton Health Plan uses the fee-for-service pharmaceutical reimbursement approach known as the maximum allowable cost (MAC) method. If Walton’s MAC list specifies a cost of 8 cents per tablet for a particular drug but the participating pharmacy pays 10 cents per tablet for the drug, then Walton will be obligated to reimburse the pharmacy for

A.

8 cents per tablet, but the pharmacy can bill the subscriber for the remaining 2 cents per tablet

B.

8 cents per tablet, and the pharmacy cannot bill the subscriber for the remaining 2 cents per tablet

C.

10 cents per tablet, but the pharmacy must refund the extra 2 cents per tablet to the subscriber

D.

10 cents per tablet, and the pharmacy is not required to refund the extra 2 cents per tablet to the subscriber

AHIP AHM-530 Summary

  • Vendor: AHIP
  • Product: AHM-530
  • Update on: Oct 14, 2025
  • Questions: 202
Price: $52.5  $149.99
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