D.C. Mun. Regs. tit. 29, § 2709
Reimbursement for Brand Name Drugs
Effective Mar 23, 201259 DCR 2298Authority: An Act to enable the District of Columbia (“District”) to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes approved December 27, 1967 (81 Stat.774; D.C. Official Code § 1-307.02 (2016 Repl.)), and Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2012 Repl.)). Source: Final Rulemaking published at 59 DCR 2298 (March 23, 2012); as amended by Final Rulemaking published at 65 DCR 7837 (July 27, 2018).District of Columbia, Office of the Secretary
2709 METHODS FOR DETERMINING COST FOR SINGLE SOURCE DRUGS
2709.1 Methods for determining costs of single source drugs are:
(a) The costs for prescribed drugs which shall not exceed the WAC, plus three percent (3%), if available;
(b) The costs for drugs that do not have a WAC shall be priced based on the direct price benchmark plus three percent (3%) as evaluated by DHCF using a national standard database; and
(b) The cost for the WAC which shall be the price, at the time of service, obtained from a nationally recognized comprehensive data file maintained by a vendor under contract with DHCF.
SOURCE: Notice of Final Rulemaking published at 59 DCR 2298, 2306 (March 23, 2012).