59G-4.250: Prescribed Drug Services
PURPOSE AND EFFECT: The purpose of this rule amendment is to incorporate by reference the Florida Medicaid Prescribed Drug Services Coverage, Limitations and Reimbursement Handbook, June 2006. The handbook incorporates statutory changes making the Preferred Drug List mandatory and removes the four brand cap limit. It also removes the 34-day supply limit for some maintenance drugs when identified by the P&T committee; eliminates the Silver Saver program; moves coverage of certain supplies and nutritional items to the Durable Medical Equipment program; defines the process for approval of a brand name drug when generic equivalent products are available; removes coverage for erectile dysfunction; adopts statutory ingredient cost reimbursement levels; and specifies a $7.50 dispensing fee for providers using 340b purchasing contracts. The effect will be to incorporate by reference in the rule the Florida Medicaid Prescribed Drug Coverage, Limitations and Reimbursement Handbook.
SUMMARY: The purpose of this rule amendment is to incorporate by reference the Florida Medicaid Prescribed Drug Services Coverage, Limitations and Reimbursement Handbook, June 2006. The effect will be to incorporate by reference in the rule the Florida Medicaid Prescribed Drug Coverage, Limitations and Reimbursement Handbook.
SUMMARY OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC AUTHORITY: 409.919 FS.
LAW IMPLEMENTED: 409.906, 409.908, 409.912 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE,TIME AND PLACE SHOWN BELOW(IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):
TIME AND DATE: Thursday, September 14, 2006, 11:00 a.m.
PLACE: Agency for Health Care Administration, 2727 Mahan Drive, Bldg 3, Conference Room B, Tallahassee, Florida
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Marie Donnelly, Agency for Health Care Administration, Medicaid Pharmacy Services, 2727 Mahan Drive, Mail Stop 38, Tallahassee, Florida, 32308, (850)922-0683
THE FULL TEXT OF THE PROPOSED RULE IS:
59G-4.250 Prescribed Drug Services.
(1) No change.
(2) All participating prescribed drug services providers enrolled in the Medicaid program must be in compliance with the provisions of the Florida Medicaid Prescribed Drug Services Coverage, Limitations, and Reimbursement Handbook, June 2006
July 2001, which is incorporated by reference, and available from the Medicaid fiscal agent’s website at http://floridamedicaid.acs-inc.com agent. Click on Provider Support, and then on Handbooks. Paper copies of the handbooks may be obtained by calling Provider Inquiry at (800)377-8216.
Specific Authority 409.919 FS. Law Implemented 409.906
(20), 409.908, 409.912 FS. History–New 1-1-77, Amended 6-30-77, 10-1-77, 2-1-78, 4-1-78, 9-28-78, 6-1-79, 2-28-80, 11-11-81, 7-3-84, Formerly 10C-7.42, Amended 3-11-86, 12-5-88, 6-4-90, 10-29-90, 5-20-92, 4-11-93, Formerly 10C-7.042, Amended 12-28-95, 8-3-97, 2-11-98, 9-13-99, 7-20-00, 1-29-01, 4-24-01, 10-6-02,_________.