New Jersey Statutes - Title 30 Institutions and Agencies - 30:4D-22.3 Payment to pharmacy for certain forged, fraudulent prescriptions, program's responsibilities.

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30:4D-22.3. Payment to pharmacy for certain forged, fraudulent prescriptions, program's responsibilities.

2. a. A pharmacy shall receive full payment and shall not be penalized for dispensing a forged or fraudulent prescription that has been approved by the State Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), unless the pharmacist or an employee or agent of the pharmacy has committed the forgery or fraud or has knowingly facilitated the commission of a forgery or fraud, or has failed to comply with the requirements set forth in subsection c. of this section.

b. As used in this section, "has committed the forgery or fraud or has knowingly facilitated the commission of a forgery or fraud" means that a person:

(1) knowingly and willfully made or caused to be made any false statement or representation of a material fact in any document or electronic transmission necessary to receive payment by the program for the prescription;

(2) knowingly and willfully made or caused to be made any false statement, written or oral, of a material fact for use in determining the right to payment by the program for the prescription; or

(3) concealed or failed to disclose a fact or the occurrence of an event that affects the right to payment by the program for the prescription.

c. The provisions of this section shall not be construed as relieving a pharmacist of his obligation to comply with any requirements provided under any State or federal statute or regulation for the pharmacist:

(1) to seek verification of a prescription from an authorized prescriber or the latter's authorized agent before filling the prescription whenever the pharmacist has reason to question the authenticity, accuracy, or appropriateness of the prescription; and

(2) to not fill the prescription when the authenticity, accuracy, or appropriateness of the prescription is in question and no such verification has been provided.
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Last modified: February 14, 2012

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New Jersey Statutes - Title 30 Institutions and Agencies - 30:4D-22.3 Payment to pharmacy for certain forged, fraudulent prescriptions, program's responsibilities.