(a) The Director of the Department of Human Services and the deputy director shall pay each participating pharmacist for each prescription filled under this program the pharmacist's usual and customary charge to the general public for the drug.
(b) However, until existing federal regulations limiting reimbursement for a drug to the lower of the pharmacist's usual and customary charge, or cost of the drug plus a reasonable dispensing fee, are modified or declared invalid by a court, the director and the deputy director shall pay for each prescription, the lower of:
(1) The pharmacist's usual and customary charge to the general public for the drug; or
(2) The pharmacist's cost of the drug plus a dispensing fee. The fee will be adjusted annually on July 1 of each year by the percentage change in the Consumer Price Index, except that on any July 1 immediately following a subsequent cost of dispensing survey conducted by the appropriate division of the Department of Human Services, the fee will be adjusted using the formula used by the director and the deputy director to determine the July 1, 1980, fee or other such formula as may be developed subsequently by the director and the deputy director with the approval of the Legislative Council.
(c) In addition to the amounts paid under subdivisions (b)(1) and (2) of this section, at such time as federal regulations shall permit, the pharmacist will also be paid any additional direct and indirect costs which are generated by participation in the Title XIX Medicaid Program. The new additional costs will be paid by the state.
Section: Previous 20-77-402 20-77-403 20-77-404 20-77-405 NextLast modified: November 15, 2016