PURPOSE: The Division of Medical Services establishes the amount of the fee reimbursable for the professional dispensing of each Medicaid-covered prescription by a pharmacy provider, raises the current dispensing fee from two dollars seventy-five cents to three dollars and establishes a longterm care prescription fee add-on.

Editor’s Note: The secretary of state has determined that the publication of this rule in its entirety would be unduly cumbersome or expensive. The entire text of the material referenced has been filed with the secretary of state. This material may be found at the 13 CSR 70-20

Office of the Secretary of State or at the headquarters of the agency and is available to any interested person at a cost established by state law.

1. (1) A dispensing fee of three dollars ($3) shall be added to the Medicaid maximum allowable payment for each Missouri Medicaid reimbursable prescription filled or refilled by a pharmacy provider.

   1. (A) The dispensing fee allowed for the dispensing of only those drugs as specified in 13 CSR 70-20.110 for the treatment of acquired immunodeficiency syndrome shall be set at ten percent (10%) of the maximum allowable drug payment.
   2. (B) The professional dispensing fees as provided in this rule shall not be included in the computation of the Missouri Medicaid maximum allowable drug payment for recipient cost-sharing purposes.

2. (2) All pharmacy providers supplying prescribed Medicaid-covered drugs to recipients 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 Division of Medical Services, 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 Medicaid Exception Process; and

1. (C) Indicate, as prescribed by the Division of Medical Services, on each claim that the prescription was provided in packaging qualifying for the dispensing fee add-on to a recipient in a long-term care facility.

AUTHORITY: sections 208.153, RSMo Supp. 1991 and 208.201, RSMo Supp. 1987.* Original rule filed Dec. 15, 1987, effective March 11, 1988. *Original authority: 208.153, RSMo 1967, amended 1973, 1989, 1990, 1991 and 208.201, RSMo 1987.