173.83 Adopting rules to implement the program.

The department of aging shall adopt rules in accordance with Chapter 119. of the Revised Code to implement the Ohio’s best Rx program. The rules shall provide for all of the following:

(A) Standards and procedures for establishing, pursuant to section 173.74 of the Revised Code, the base price for each drug included in the program;

(B) Determination of family income for the purpose of division (A)(2)(a) of section 173.76 of the Revised Code;

(C) For the purpose of section 173.77 of the Revised Code, the application process for the program, including the information and documentation to be submitted with applications to verify eligibility and a process to be used in certifying that an applicant has attested to the accuracy of the submitted information and documentation;

(D) The method of providing information about the medicaid program to applicants under section 173.771 of the Revised Code;

(E) For the purpose of section 173.772 of the Revised Code, eligibility determination procedures;

(F) Standards and procedures governing the drug mail order system included in the program pursuant to section 173.78 of the Revised Code;

(G) Subject to section 173.831 of the Revised Code, periodically increasing the maximum professional fee that participating terminal distributors may charge Ohio’s best Rx program participants pursuant to an agreement entered into under section 173.79 of the Revised Code;

(H) Subject to section 173.832 of the Revised Code, the amount of the administrative fee, if any, that Ohio’s best Rx program participants are to be charged under the program;

(I) The electronic method for submission of claims to the department under section 173.80 of the Revised Code;

(J) Additional information to be included on claims submitted under section 173.80 of the Revised Code that the department determines is necessary for the department to be able to make payments under section 173.801 of the Revised Code;

(K) The method for making payments under section 173.801 of the Revised Code;

(L) Subject to section 173.833 of the Revised Code, the percentage, if any, that is the program administration percentage;

(M) If the department determines it is best that participating manufacturers make payments pursuant to manufacturer agreements entered into under section 173.81 of the Revised Code on a basis other than quarterly, a schedule for making the payments;

(N) Procedures for making computations under sections 173.75 and 173.812 of the Revised Code;

(O) Standards and procedures for the use and preservation of records regarding the Ohio’s best Rx program pursuant to section 173.91 of the Revised Code;

(P) The efficient administration of other provisions of sections 173.71 to 173.91 of the Revised Code for which the department determines rules are necessary.

Effective Date: 07-01-2007