Code of Massachusetts Regulations
130 CMR - DIVISION OF MEDICAL ASSISTANCE
Title 130 CMR 406.000 - Pharmacy Services
Section 406.436 - Disclosure of Information
Current through Register 1531, September 27, 2024
In order for the MassHealth agency to verify a pharmacy's compliance with 101 CMR 331.00: Prescribed Drugs, a pharmacy must, upon request, make available to the MassHealth agency for inspection and copying the following documentation:
(A) all prescriptions (for both members and nonmembers) filled during the time period specified by the MassHealth agency with the names of the patients and all other identifying information blocked out;
(B) all documentation of a drug's cost to the pharmacy provider, all documentation regarding the amount the pharmacy provider has charged any entity, and the amount any purchaser or reimburser has paid the pharmacy provider for any drug covered by MassHealth. This must include, but is not limited to, all documentation used to calculate charges billed to the MassHealth agency for any given date. In addition, all reports, books, and records related to its operation must be available for audit.