173.812 Calculation of manufacturer payment amounts.

When a drug included in a manufacturer agreement entered into under section 173.81 of the Revised Code is dispensed under the Ohio’s best Rx program, the manufacturer payment amount that applies to the transaction shall be established in accordance with the following:

(A) For purposes of the amount to be paid by the manufacturer, the manufacturer payment amount shall be computed by multiplying the per unit amount specified for the drug in the manufacturer agreement by the number of units dispensed.

(B) For purposes of the amount that a participant is to be charged under section 173.75 of the Revised Code and the amount to be paid for claims under section 173.801 of the Revised Code, both of the following apply:

(1) If a program administration percentage is not determined by the department of aging in rules adopted under section 173.83 of the Revised Code, the manufacturer payment amount shall be the same as the manufacturer payment amount computed under division (A) of this section.

(2) If a program administration percentage is determined by the department, the manufacturer payment amount shall be computed as follows:

(a) Multiply the per unit amount specified for the drug in the agreement by the program administration percentage;

(b) Subtract the product determined under division (B)(2)(a) of this section from the per unit amount specified for the drug in the agreement;

(c) Multiply the per unit amount resulting from the computation under division (B)(2)(b) of this section by the number of units dispensed.

Effective Date: 07-01-2007