PURPOSE: The MO HealthNet Division establishes the amount of the fee reimbursable for the professional dispensing of each MO HealthNet covered prescription by a pharmacy provider, raises the current dispensing fee from three dollars ($3) to four dollars eighty-four cents ($4.84) and establishes a long-term care prescription fee addon of fifteen cents (15¢).

PUBLISHER’S NOTE: The secretary of state has determined that the publication of the entire text of the material which is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. Therefore, the material which is so incorporated is on file with the agency who filed this rule, and with the Office of the Secretary of State. Any interested person may view this material at either agency’s headquarters or the same will be made available at the Office of the Secretary of State at a cost not to exceed actual cost of copy reproduction. The entire text of the rule is printed here. This note refers only to the incorporated by reference material.

1. (1) A dispensing fee of four dollars eightyfour cents ($4.84) shall be added to the MO HealthNet maximum allowable payment for each MO HealthNet reimbursable prescription filled or refilled by a pharmacy provider.

   1. (A) The professional dispensing fees as provided in this rule shall not be included in the computation of the MO HealthNet maximum allowable drug payment for participant cost-sharing purposes.

2. (2) All pharmacy providers supplying prescribed MO HealthNet covered drugs to participants in long-term care facilities shall receive an additional fifteen cent (15¢) dispensing fee per claim provided they—

   1. (A) Dispense medication in a drug distribution system(s) which meets minimum standards of container packaging (at least class B as defined in United States Pharmacopeia XXI);

   2. (B) Certify to the MO HealthNet Division, on a form, and in the manner prescribed by the division, that they—

      1. 1. Provide this dispensing service to

their long-term care facility resident patients;

1. 2. Provide emergency services twenty-

four (24) hours a day with seven (7) days a week availability; and

1. 3. Have ability and willingness to assist

in accessing medications through the MO HealthNet Exception Process; and

1. (C) Indicate, as prescribed by the MO HealthNet Division, on each claim that the prescription was provided in packaging qualifying for the dispensing fee add-on to a participant in a long-term care facility. AUTHORITY: sections 208.153 and 208.201, RSMo Supp. 2013.* Original rule filed Dec. 15, 1987, effective March 11, 1988. Amended: Filed Sept. 26, 2013, effective March 30, 2014. *Original authority: 208.153, RSMo 1967, amended 1973, 1989, 1990, 1991, 2007, 2012 and 208.201, RSMo 1987, amended 2007.