Current through all regulations passed and filed through September 16, 2024
(A)
Payment for
prescribed drugs is the lesser of the provider's billed charges or the
calculated allowable, after any coordination of benefits is applied as
described in paragraph (E) of this rule. For prescribed drugs that are subject
to a co-payment, the amount paid by the Ohio department of medicaid (ODM) is
decreased by the amount equal to the co-payment billed to the recipient in
accordance with rules
5160-1-09 and
5160-9-09 of the Administrative
Code.
(B)
The ingredient cost portion of the calculated allowable
is determined in accordance with the following criteria:
(1)
No ingredient
cost is allowed for a pandemic vaccine or any other medication, provided by the
Ohio department of health or other government entity at no cost to the
provider.
(2)
For any drug purchased under the 340B program, the
ingredient cost is the lesser of submitted ingredient cost or the 340B ceiling
price. If the 340B ceiling price is not available, the ingredient cost is the
lesser of the submitted ingredient cost or fifty per cent of wholesale
acquisition cost (WAC) If WAC is not available, the ingredient cost is the
lesser of submitted ingredient cost or Ohio average acquisition cost
(OAAC).
(3)
For a clotting factor, the ingredient cost is the
lesser of submitted ingredient cost or the payment limit shown in the current
medicare part B drug pricing file, minus the furnishing fee assigned by
medicare part B. The medicare part B pricing file is available at
https://www.cms.gov.
(4)
For all other ingredients not captured in paragraphs
(B)(1) to (B)(3) of this rule the ingredient cost is the lesser of submitted
ingredient cost or national average drug acquisition cost (NADAC). If the
centers for medicare and medicaid services (CMS) has not published a NADAC for
the ingredient for the date of service, the ingredient cost is the lesser of
submitted ingredient cost, OAAC, or WAC.
(C)
The
administration fee portion of the calculated allowable for a vaccine, except
for a vaccine for COVID-19, or other injectable drug administered at the
pharmacy is nineteen dollars thirty-five cents. The administration fee for a
vaccine for COVID-19 equals the medicare rate.
(D)
The professional
dispensing fee (PDF) portion of the calculated allowable is determined in
accordance with the following criteria:
(1)
The PDF to a
provider for dispensing a non-compounded drug is assigned on the total number
of prescriptions filled by the provider during the provider's last completed
fiscal year prior to completing the required cost of dispensing survey and
reported on the survey. The PDF is assigned in accordance with the following
criteria:
(a)
PDF payment amounts for dates of service prior to January 1,
2024:
(i)
For
providers reporting fewer than fifty thousand prescriptions, thirteen dollars
and sixty-four cents.
(ii)
For providers reporting between fifty thousand and
seventy-four thousand nine hundred ninety-nine prescriptions, ten dollars and
eighty cents.
(iii)
For providers reporting between seventy-five thousand
and ninety-nine thousand nine hundred ninety-nine prescriptions, nine dollars
and fifty-one cents.
(iv)
For providers reporting one hundred thousand or more
prescriptions, eight dollars and thirty cents.
(v)
For a provider
who failed to submit a complete response to the required cost of dispensing fee
survey for the previous reporting period, eight dollars and thirty
cents.
(vi)
For providers newly enrolled as medicaid providers as
described in rule
5160-9-06 of the Administrative
Code, the PDF is as follows:
(a)
For a new provider located in Ohio, the provider is assigned
a PDF of thirteen dollars and sixty-four cents.
(b)
For a new provider located outside of Ohio, the provider is
assigned a PDF of eight dollars and thirty cents.
(b)
PDF
payment amounts for dates of service on or after January 1, 2024:
(i)
For providers
reporting fewer than fifty thousand prescriptions, fifteen dollars and
forty-seven cents.
(ii)
For providers reporting between fifty thousand and
seventy-four thousand nine hundred ninety-nine prescriptions, eleven dollars
and forty cents.
(iii)
For providers reporting between seventy-five thousand
and ninety-nine thousand nine hundred ninety-nine prescriptions, nine dollars
and fifty-one cents.
(iv)
For providers reporting one hundred thousand
prescriptions or greater, eight dollars and thirty cents.
(v)
For providers
newly enrolled as medicaid providers as described in rule
5160-9-06 of the Administrative
Code, the PDF is as follows:
(a)
For a new provider located in Ohio, the provider is assigned
a PDF of fifteen dollars and forty-seven cents.
(b)
For a new provider located outside of Ohio, the provider is
assigned a PDF of eight dollars and thirty cents.
(2)
The PDF paid to a provider for dispensing compounded
drugs is paid in accordance with the following criteria:
(a)
The PDF for
claims for dispensing total parenteral nutrition (TPN) is fifteen dollars per
one-day supply on the claim, with a maximum total PDF of one hundred fifty
dollars for the claim. To qualify for the TPN PDF, the TPN compound must be
mixed by the pharmacy to the final form under sterile conditions. If the
products are mixed or activated at the point of administration by connecting
components or breaking seals without the need for sterile conditions, the
dispensing does not qualify for payment of the compounded PDF.
(b)
The PDF for
dispensing sterile compounds, other than TPN, that are required to be sterile
for a route of administration including inhaled, infused, instilled, implanted
or injected, is ten dollars per day's supply, a maximum of seventy dollars for
the claim. To qualify for payment of the sterile compound PDF, the sterile
compound must be mixed by the pharmacy to the final form under sterile
conditions. Products mixed or activated at the point of administration by
connecting components or breaking seals without the need for sterile conditions
are not eligible for a sterile compound PDF.
(c)
Compounded drugs
that are not eligible for the TPN or sterile compound PDF will receive the PDF
determined under paragraph (D) of this rule.
(3)
Vaccine or
injectable drug dispensing that qualifies for payment of an administration fee
does not qualify for medicaid payment of a PDF.
(4)
Notwithstanding
paragraph (D)(1) of this rule, prescribed drugs, other than compounded drugs,
dispensed to recipients residing in long term care facilities (LTCFs) are
limited to one PDF per patient, per equivalent product, per month. If multiple
supplies of an equivalent product are dispensed within the same month, only the
ingredient cost will be paid. Exceptions to the one PDF per recipient, per
product rule are:
(a)
The prescriber ordered a second round of medication for
an acute condition within the month.
(b)
The prescriber
changed the dosage.
(c)
The drug was compromised by accident, including but not
limited to being contaminated or destroyed.
(E)
Coordination of benefits.
(1)
Claims for
medicare part B cost sharing as described in rule
5160-1-05 of the Administrative
Code are submitted using the medical claim format and are not payable under
this chapter.
(2)
No payment will be made under this chapter for any drug
that may be covered by medicare part D for an recipient who is eligible for
coverage by medicare part D, regardless of whether the recipient is actually
enrolled in a part D plan or the particular drug is covered by the recipient's
part D plan.
(3)
Cost-sharing for claims involving neither medicare part
B nor medicare part D is determined in accordance with rule
5160-1-08 of the Administrative
Code.
Replaces: 5160-9-05