[Provider] Proposed MaineCare Rule for Chapter II, Section 45, Hospital Services

[Provider Notification]

ATTENTION:  MaineCare Providers of Physician Administered Drugs

 

Rule Title or Subject:        

MaineCare Benefits Manual, Chapter II, Section 45, Hospital Services

 

Concise Summary:

The proposed changes require hospitals to report NDC drug utilization to
the Department for physician administered drugs, often referred to as "j
code" drugs.  Hospitals designated as "340 B hospitals" will be exempt
from this requirement. The US Centers for Medicare and Medicaid Services
(CMS) has required that state Medicaid programs have in place a
mechanism for collecting National Drug Codes (NDC Codes) on all
physician-administered drugs. The purpose of this requirement is to
allow states to continue to collect negotiated rebates from drug
manufacturers for drugs paid for by Medicaid programs. The proposed rule
will require hospitals to submit quarterly utilization reports of the
Medicaid Top 20 Physician-Administered Multiple Source Drugs ("j code"
drugs), listed at:
http://www.cms.hhs.gov/DeficitReductionAct/Downloads/Top20PhysicianAdmin
istered.pdf.

 

The Department has determined that a failure to comply with this
reporting requirement is a sanction, as defined in MBM, Chapter I,
Section I, 1.19.  The Department has determined that the sanction it
will impose for such failure will be the offset of seven percent (7%) of
PIP payments, which is further detailed in the proposed rule.  This
proposed rule does not have any adverse impact on small business.  

 

PUBLIC HEARING:   

No public hearing is scheduled.   

 

DEADLINE FOR COMMENTS:      

Comments must be received by midnight August 1, 2008.

 

AGENCY CONTACT PERSON:       

Patricia Dushuttle, Manager, Division of Policy and Performance

 

This proposed rule can be found on the MaineCare Services web site at:

http://www.maine.gov/bms/rules/provider_proposed_mcare.shtml

 

 

This is a one-way communication.  Please do not respond to this message.

 

 

 

 

 

 

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