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 “prescribed drugs” category of service, and “other providers” with a “prescribed drugs” 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 rule 5101:3-1-17.2 of the Administrative Code and signs a provider agreement pursuant thereto.

(B) A “hospital” provider acting as a pharmacy in accordance with paragraphs (A)(1) to (A)(3) of this rule can obtain a “prescribed drug” category of service and provide self-administered, take-home drugs.

(C) “Other providers” who 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 “prescribed drug” category of service.

Effective: 04/14/2005

R.C. 119.032 review dates: 01/28/2005 and 04/01/2010

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