PR Health Insurance Administration (ASES)

ASES

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abarca health performs Pharmacy Program Administration (PPA) services for the PR Government Health Insurance Plan (PRGHIP), which is administered by the PR Health Insurance Administration (ASES) with federal Medicaid and state funds. The PRGHIP covers approximately 1.4 million lives. As PPA for ASES, abarca health is responsible for providing the following services: rebate program management services for branded drug products; development and maintenance of the Maximum Allowable Cost (MAC) List for generic drug products; and development of Covered Medication Formularies (FMCs) for the program, among other services.

abarca health has served as PPA for ASES since late 2006. In its role as PPA, abarca health has worked with ASES to significantly increase drug discounts in the form of rebates and help stem inflation through its dynamic MAC pricing.

Important resources on this page (2015-2016): PRGHIP beneficiaries and providers will find medication formularies on this page. In order to access these resources, please click on the links below.

The following Covered Medication Formularies (FMCs) serve to guide specific providers on medication decisions under the most updated cost-effective coverage.

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