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<p class=MsoNormal><b><font size=4 face=Arial><span style='font-size:14.0pt;
font-family:Arial;font-weight:bold'>ATTENTION:</span></font></b><font size=4
face=Arial><span style='font-size:14.0pt;font-family:Arial'> <b><u><span
style='font-weight:bold'>MaineCare Providers of Physician Administered Drugs<o:p></o:p></span></u></b></span></font></p>
<p class=MsoNormal><b><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial;font-weight:bold'><o:p> </o:p></span></font></b></p>
<p class=MsoNormal><b><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial;font-weight:bold'>Rule Title or Subject: <o:p></o:p></span></font></b></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>MaineCare Benefits Manual, Chapter II, Section 45, Hospital
Services<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial;font-weight:bold'>Concise Summary:<o:p></o:p></span></font></b></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>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: <a
href="http://www.cms.hhs.gov/DeficitReductionAct/Downloads/Top20PhysicianAdministered.pdf"
title="http://www.cms.hhs.gov/DeficitReductionAct/Downloads/Top20PhysicianAdministered.pdf">http://www.cms.hhs.gov/DeficitReductionAct/Downloads/Top20PhysicianAdministered.pdf</a>.<o:p></o:p></span></font></p>
<p class=MsoBlockText style='margin-left:.5in;text-indent:0in'><font size=3
face=Arial><span style='font-size:12.0pt;font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoBlockText style='margin-left:0in;text-indent:0in'><font size=3
face=Arial><span style='font-size:12.0pt;font-family:Arial'>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. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial;font-weight:bold'>PUBLIC HEARING:</span></font></b><font
face=Arial><span style='font-family:Arial'> <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>No public hearing is scheduled. <b><span
style='font-weight:bold'><o:p></o:p></span></b></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><b><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial;font-weight:bold'>DEADLINE FOR COMMENTS:</span></font></b><font
face=Arial><span style='font-family:Arial'> <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>Comments must be received by midnight August 1, 2008.<o:p></o:p></span></font></p>
<p class=MsoNormal><b><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial;font-weight:bold'><o:p> </o:p></span></font></b></p>
<p class=MsoNormal><b><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial;font-weight:bold'>AGENCY CONTACT PERSON:</span></font></b><font
face=Arial><span style='font-family:Arial'>
<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>Patricia Dushuttle, Manager, Division of Policy and
Performance<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'>This proposed rule can be found on the MaineCare Services
web site at:<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><a
href="http://www.maine.gov/bms/rules/provider_proposed_mcare.shtml">http://www.maine.gov/bms/rules/provider_proposed_mcare.shtml</a><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><i><font size=1 face=Arial><span style='font-size:9.0pt;
font-family:Arial;font-style:italic'>This is a one-way communication.
Please do not respond to this message.<o:p></o:p></span></font></i></p>
<p class=MsoNormal><i><font size=1 face=Arial><span style='font-size:9.0pt;
font-family:Arial;font-style:italic'><o:p> </o:p></span></font></i></p>
<p class=MsoNormal><i><font size=1 face=Arial><span style='font-size:9.0pt;
font-family:Arial;font-style:italic'><o:p> </o:p></span></font></i></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face=Arial><span style='font-size:12.0pt;
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