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-1.9 - Prescription drug dispensing fee
Current through Register Vol. 56, No. 18, September 16, 2024
(a) The dispensing fee for each prescription dispensed to recipients by providers having retail permits, and where PAAD is the primary payer is $ 3.73 to $ 3.99. Additional dispensing fees (add-ons) per prescription shall be given, when PAAD is the primary payer, to pharmacy providers who provide the following:
(b) Price information is supplied from a reference drug file subcontracted for this purpose by the fiscal agent and accepted by the Division as the primary source of pricing information for the New Jersey Medicaid Management Information System (NJMMIS). The calculated price shall not exceed the lower of the average wholesale price (AWP) or the Federal Fund Participation Upper Limit (FFPUL) as supplied by the reference drug file contractor.
(c) In order to receive any or all of the above increments, the provider shall certify annually to the Division on Form FD-70, that the services, as defined in (a) above, are being provided and/or that the provider is entitled to the impact increment as defined in (a) above.
(d) Failure to submit the report required by (c) above annually shall result in retail pharmacy provider payments based on the basic dispensing fee of $ 3.73.