New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 167A - PROVISION OF PHARMACEUTICAL SERVICES UNDER THE PHARMACEUTICAL ASSISTANCE TO THE AGED AND DISABLED PROGRAM (PAAD)
Subchapter 1 - REQUIREMENTS FOR PROVISION OF PHARMACEUTICAL SERVICES
Section 10:167A-1.20 - Prescription refill
Universal Citation: NJ Admin Code 10:167A-1.20
Current through Register Vol. 56, No. 18, September 16, 2024
(a) The provider shall submit an electronic claim in the proper EMC claim format to the fiscal agent for reimbursement of an allowable refill. An allowable refill shall comply with the following instructions in order to be reimbursed as such:
1. Refill instructions shall be indicated in writing by the prescriber on
the original prescription, on a facsimile of the prescription, in the electronic prescription, or verbally
when telephoning the original prescription to the pharmacist. Verbal instructions shall be reduced to writing
by the pharmacist.
2. The original prescription is valid for the
12 month period beginning with the date of the original prescription. There is no limit to the number of
refills dispensed during the 12 month period.
i. Exception: Oral
contraceptives originally prescribed for three ovulatory cycles may be refilled up to three times within one
year if so indicated by the prescriber on the original prescription.
3. Refill instructions indicating "refill prn" or indicating more than five
refills, shall be subject to the limits imposed in (a)2 above, and shall be reimbursed up to these limits
only.
4. An authorized refill for a prescription with no refill
remaining must be assigned a new prescription number.
5.
Prescription refills shall not be dispensed until 85 percent of the medication originally dispensed or
refilled could have been consumed in accordance with the prescriber's written directions for use.
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