5101:3-9-01 Eligible providers of pharmacy services.

Three types of providers are eligible for reimbursement for pharmacy services: "pharmacy providers," "hospitals" with a "pharmacy" category of service, and "clinics" with a "pharmacy" category of service.

(A) A "pharmacy provider" designation and provider number can be obtained by a "terminal distributor of dangerous drugs," as defined in section 4729.01 of the Revised Code, who also:

(1) Has a valid drug enforcement agency (DEA) number; and

(2) Has a licensed registered pharmacist in full and actual charge of a pharmacy; and

(3) Complies with eligible provider rules 5101:3-1-17 to

5101:3-1- 17.4 of the Administrative Code and signs a provider agreement with the Ohio department of job and family services.

(B) A "hospital" provider acting as a pharmacy in accordance with paragraphs (A)(1) to (A)(3) of this rule can obtain a "pharmacy" category of service and bill for self-administered take-home drugs.

(C) "Clinic" providers that have a valid medicaid provider agreement and have met the criteria under the Revised Code for dispensing pharmaceuticals but are not eligible to become a "pharmacy provider" as defined in paragraph (A) of this rule, are eligible to apply for a "pharmacy" category of service and bill for self-administered take-home drugs.

Effective: 08/02/2011
R.C. 119.032 review dates: 09/20/2010 and 08/01/2016
Promulgated Under: 119.03
Statutory Authority: 5111.02
Rule Amplifies: 5111.01, 5111.02
Prior Effective Dates: 4/7/77, 9/19/77, 12/21/77, 12/30/77, 7/8/78, 10/1/78, 5/9/86, 11/1/86, 10/1/87, 2/1/88, 1/13/89 (Emer), 4/13/89, 6/1/89, 7/1/94, 10/1/97, 2/3/00 (Emer), 5/1/00, 04/14/05