Ala. Admin. Code r. 560-X-16-.02
Current through Register Vol. 43, No. 1, October 31, 2024
Section 560-X-16-.02 - Requirements For Participation(1) A pharmacy must be operating under a permit or license to dispense drugs as issued by the Alabama State Board of Pharmacy or appropriate authority in the state where the service is rendered.(2) A pharmacy applicant must submit and have approved a pharmacy agreement signed by owner, authorized representative, pharmacist, or dispensing physician.(3) Pharmacies and dispensing physicians must agree to abide by the rules and regulations of the program; must agree that payment for covered services will be accepted as payment in full.(4) Pharmacy providers must agree to abide by the rules and regulations of third party billing procedures (See Chapter 20 Third Party).(5) Pharmacy providers must agree to keep records, including prescriptions, to fully disclose extent of services rendered. Records, including purchase invoices, recipient signature logs, etc., should be maintained within the State of Alabama. At a minimum the following records and/or documentation must be available for examination: (1) prescription files and (6) Pharmacy providers must agree that the Alabama Medicaid Agency or its representative may conduct audits of required records as necessary. Invoice records must be maintained and be readily available for inspection. If, due to the location of the provider's records, Medicaid personnel are required to go out of state for an audit, the organization being audited will bear all expenses and costs related to the audit, including, but not limited to, travel and reasonable living expenses.(7) All Medicaid participating pharmacies must be in compliance with Title VI and VII of the Civil Rights Act of 1964 and with Section 504 of the Rehabilitation Act of 1973. Authors: Susan Mims, Larry A. Tatum
Ala. Admin. Code r. 560-X-16-.02
Rule effective October 1, 1982. Amended: Effective October 7, 1983; April 14, 1992. Amended: Filed February 7, 1994; effective March 15, 1994. Amended: Filed January 6, 1998; effective February 10, 1998.Statutory Authority: State Plan, Attachments 3.1A, 4.18B; Title XIX, Social Security Act; 42 C.F.R. §§401, et seq., 447.331; Omnibus Budget Reconciliation Act of 1990 ( Public Law 101-508 ).