D.C. Mun. Regs. tit. 29, r. 29-2701

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 29-2701 - PROVIDER PARTICIPATION

2701.1

A provider of pharmacy services shall be a licensed pharmacy. To participate in the District of Columbia's Medicaid Program, the provider shall:

(a) Fully comply with any applicable District, state and federal laws or regulations governing the provision and reimbursement of pharmacy services; and

(b) Complete and sign the Medicaid Provider Agreement.

2701.2

As a condition of participation, the provider shall be required to comply with the following requirements:

(a) Perform prospective drug utilization review before dispensing each prescription. This shall include screenings for, but not limited to, the following:

(1) Therapeutic duplication;

(2) Drug-disease contraindications;

(3) Drug interactions;

(4) Incorrect dosage indication, or duration;

(5) Drug allergies; and

(6) Abuse or misuse;

(b) Provide patient counseling on all matters which, in the provider's professional judgment, shall be deemed significant, including:

(1) Name and/or description of the medication;

(2) Route, dosage form, and duration of therapy;

(3) Directions for use;

(4) Common side effects;

(5) Potential adverse reactions, contraindications;

(6) Storage; and

(7) Re fill information;

(c) Obtain, record, and maintain patient profiles including the following:

(1) Name, address, phone number, age and gender;

(2) Individual history (i.e., diseases, allergies, drug reactions);

(3) Comprehensive listing of medications; and

(4) Relevant comments; and

(d) Cooperate with any District of Columbia Medicaid Program initiatives to provide information to beneficiaries at the point of sale including, but not limited to:

(1) Prominently displaying posters or notices; and

(2) Providing beneficiaries with individualized notices, letters, or pamphlets.

D.C. Mun. Regs. tit. 29, r. 29-2701

Notice of Final Rulemaking published at 59 DCR 2298, 2300 (March 23, 2012); amended by Final Rulemaking published at 65 DCR 7824 (7/27/2018)

Authority: The Director of the Department of Health Care Finance (DHCF), pursuant to the authority set forth in An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat. 774; D.C. Official Code § 1-307.02 (2006 Repl. & 2011 Supp.)) and section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2008 Repl.)).