Health, Health Care Financing, Coverage and Reimbursement Policy

Rule R414-60

Medicaid Policy for Pharmacy Program

Five-Year Notice of Review and Statement of Continuation

DAR File No.: 36129
Filed: 04/30/2012 04:29:12 PM

NOTICE OF REVIEW AND STATEMENT OF CONTINUATION

Concise explanation of the particular statutory provisions under which the rule is enacted and how these provisions authorize or require the rule:

Section 26-18-3 requires the Department to implement Medicaid policy through administrative rules, which allow the Department to administer the Medicaid program. In addition, Section 26-1-5 authorizes the Department to adopt rules that provide services for Medicaid recipients. Further, Subsection 58-17b-606(4) spells out the reimbursement requirement and exception for generic and non-generic drugs.

Summary of written comments received during and since the last five-year review of the rule from interested persons supporting or opposing the rule:

The Department did not receive any written or oral comments regarding this rule.

Reasoned justification for continuation of the rule, including reasons why the agency disagrees with comments in opposition to the rule, if any:

This rule is necessary because it establishes requirements and limitations for eligibility, program access, and Medicaid drug coverage. It is also necessary because it implements the copayment policy for prescription drugs and directs pharmacy providers to the methodology used for reimbursement. Therefore, this rule should be continued.

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Direct questions regarding this rule to:

• Craig Devashrayee at the above address, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at [email protected]

Authorized by:

David Patton, Executive Director

Effective:

04/30/2012