PURPOSE: This rule establishes that when a pharmacy dispenses drugs in a controlleddose delivery system, the pharmacy must give the MO HealthNet Division credit for any unused portion of the drug that is reusable in accordance with applicable federal or state law.

1. (1) Definitions.

   1. (A) Controlled-dose delivery system. A controlled-dose delivery system is defined as a system of dispensing of medications on behalf of a resident in a long-term care facility in manufacturer’s unit dose packaging or pharmacist packager’s unit dose, unit-of-use, or strip packaging with each tablet or capsule individually wrapped, or in blister cards, all of which must be dispensed according to applicable state and federal laws or regulations.
2. (2) The return and reuse of drugs must follow guidelines set by the State Board of Pharmacy in 20 CSR 2220-3.040, as amended.
3. (3) When a pharmacy dispenses drugs in a controlled-dose delivery system the pharmacy must give the MO HealthNet Division credit 13 CSR 70-20

for all reusable items (any unused portion) not taken by the MO HealthNet participant. In instances in which charges have been submitted prior to the return of an item the pharmacy shall file an adjustment to notify the MO HealthNet Division of the need to process a credit. The dispensing pharmacy that receives the returned drugs must provide a credit to the MO HealthNet Division for the amount reimbursed for drug costs from which the prescription was billed, prorated to the quantity of the drug returned. The credited amount should not include dispensing fees.

AUTHORITY: sections 208.153, 208.201, and 660.017, RSMo 2016.* Original rule filed Dec. 15, 2000, effective July 30, 2001. Amended: Filed Sept. 16, 2013, effective March 30, 2014. Amended: Filed April 18, 2018, effective Nov. 30, 2018.

*Original authority: 208.153, RSMo 1967, amended 1973, 1989, 1990, 1991, 2007, 2012; 208.201, RSMo 1987, amended 2007; and 660.017, RSMo 1993, amended 1995.