Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1101 - GENERAL PROVISIONS
FEES AND PAYMENTS
Section 1101.75a - Business arrangements between nursing facilities and pharmacy providers-statement of policy

Universal Citation: 55 PA Code ยง 1101.75a

Current through Register Vol. 54, No. 44, November 2, 2024

(a) General. The following listings, which are not all-inclusive, set forth examples of items and practices that would be considered accepted or improper under the Program.

(b) Accepted practices. Ancillary enhancements that are solely confined to the practice of pharmacy as defined in section 2(11) of the Pharmacy Act (63 P. S. § 390-2(11)) and remain in the control and ownership of the pharmacy would be considered an accepted practice under section 1407(a)(2) of the Public Welfare Code (62 P. S. § 1407(a)(2)) and § 1101.75(a)(3) (relating to provider prohibited acts).

(c) Examples of accepted practices. Examples of accepted practices include:

(1) Medication carts whether the pharmacy uses unit dose or standard prescription containers.

(2) Treatment and medication forms that are already part of the pharmacy's software and may be supplied to the nursing facility. The nursing facility shall pay for the cost of paper.

(d) Examples of improper practices. Examples of improper practices include:

(1) Cash or equipment in which ownership or control is changed.

(2) Funding for parties. This includes money, food or decorations.

(3) Vacation trips and professional seminars.

(4) Free or below market value items.
(i) Pharmacy consultations which include reviewing charts, conducting education sessions and observing nurses administering medication. The market value of a pharmacy consultant's fee shall be at least the average hourly wage of a pharmacist in that particular geographic area.

(ii) Drugs-legend or over-the-counter (OTCs).

(iii) Intravenous drugs, tubing or related items.

(iv) Drugs for emergency carts.

(v) Facsimile machines. This is not to preclude the use of facsimile machines. The State Board of Pharmacy will continue to regulate the proper use of facsimile machines. The prohibition includes a pharmacy placing by loan, gift or rental a facsimile machine in a nursing facility for the purpose of transmitting MA prescriptions.

(vi) Treatment or external medication carts. This does not include medication carts used exclusively to store drugs whether dispensed in a container or unit dose.

(vii) Computers and software.

(viii) Medical or pharmacy books and journals.

(ix) Prescriptions for nursing facility staff.

(x) Administrative functions which include billing, payroll and nursing facility report preparation. This does not include reports regarding drug usage.

(xi) Staff to perform nursing facility functions outside the practice of pharmacy.

(e) For the purpose of subsection (d)(4)(ii)-(iv) the Department will accept a volume discount as market value if it remains equal to or above the actual acquisition cost of the product.

Disclaimer: These regulations may not be the most recent version. Pennsylvania may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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