173.814 Annual review of sample manufacturer payments.

Annually, the department of aging shall select a sample of not more than ten of the drugs that were included in the manufacturer agreements entered into under section 173.81 of the Revised Code in the immediately preceding year. The department shall submit to the program’s consulting pharmacy benefit manager selected under section 173.731 of the Revised Code information that identifies the per unit amount of the manufacturer payments that applied to each of the drugs in the sample.

The consulting pharmacy benefit manager shall review the submitted information. After the review, the consulting pharmacy benefit manager shall provide information to the department verifying whether any of the per unit payment amounts that applied to the selected drugs were more than two per cent lower than the per unit payment amounts negotiated by the consulting pharmacy benefit manager for the same drugs in connection with health benefit plans that generally do not use formularies to restrict the outpatient drug coverage included in the plans. The consulting pharmacy benefit manager shall specify which, if any, of the drugs in the sample were subject to the lower per unit payment amounts. The information provided to the department shall be certified by signature of an officer of the consulting pharmacy benefit manager.

Effective Date: 07-01-2007