Pharmacy Providers. As applicable, Providers who are pharmacy providers agree to comply with the following:
i) 340B covered entities, and the entity’s 340B contract pharmacies, shall submit National Council for Prescription Drug Programs (NCPDP) code “08” in Basis of Cost Determination field 423-DN or in Compound Ingredient Basis of Cost Determination field 490-UE at the point of sale to identify claims submitted for drugs purchased through the 340B program;
ii) 340B covered entities shall identify outpatient hospital and physician- administered drug claims submitted for drugs purchased through the 340B program using a UD modifier or other claim modifiers defined by the Department. 42 C.F.R. § 438.3(s)(3);
iii) 340B covered entities’ written agreements with contracted pharmacies shall specify that contract pharmacies comply with the point of sale identification of drugs purchased through the 340B program. 42 C.F.R. § 438.3(s)(3); and
iv) Pharmacy providers that retroactively identify 340B claims, shall resubmit the claims with the appropriate NCPDP 340B claims identification codes. 42 C.F.R. § 438.3(s)(3).
Pharmacy Providers. In accordance with OAC 535:15-3-9, any pharmacy located outside the State of Oklahoma providing pharmacy services to Oklahoma residents must be licensed by the Oklahoma State Board of Pharmacy. Additionally, the pharmacist in charge must also be licensed by the Oklahoma State Board of Pharmacy. (State Contract § 1.14.3.5) This schedule sets forth the provisions that are required by State or federal law to be included in the Agreement with respect to the Medicaid Product. Any additional Regulatory Requirements that may apply to the Coverage Agreements or Enrollees enrolled in or covered by this Product may be set forth in the Provider Manual or another Addendum. To the extent that a Coverage Agreement, or an Enrollee, is subject to the law cited in the parenthetical at the end of a provision on this Schedule B, such provision will apply to the rendering of Covered Services to an Enrollee with such Coverage Agreement, or to such Enrollee, as applicable.
Pharmacy Providers. 3.2.6.1. The Contractor shall provide or enter into subcontracts with qualified pharmacy Providers for the provision of Covered Drugs as required, and in the manner specified, by Department regulations at 00 X.X.X. 0000-10, Section 8.
Pharmacy Providers. For pharmacy contracts, the pharmacy benefits manager should provide the following electronic message alerting the pharmacist to provide Medicaid recipients with the HSA notice/pamphlet when coverage is rejected due to the drug not being on the Preferred Drug List (PDL):
