(a) Participating retail pharmacies shall submit claims to the Department to verify the amount charged to qualified residents and to receive reimbursement.
(b) The Department shall not impose transaction charges on participating retail pharmacies that submit claims or receive payments under AccessRx.
(c) On a periodic basis, to be established by the Department, the Department shall reimburse a participating retail pharmacy for:
(1) The discounted price provided to uninsured qualified residents pursuant to § 48-831.33; and
(2) Prescription drugs dispensed to low-income elderly pursuant to § 48-831.23.
(d) The Department shall conduct ongoing quality assurance activities similar to those used in the D.C. Medicaid program.
(e) The Department shall collect utilization data from participating retail pharmacies submitting claims necessary to calculate the amount of the rebate from the manufacturer or labeler. The Department shall protect the confidentiality of all information subject to confidentiality protection under District or federal law, rule or regulation.
(May 18, 2004, D.C. Law 15-164, § 107, 51 DCR 3688.)
Structure District of Columbia Code
Chapter 8A - Affordability of Prescription Drugs — AccessRx Program
§ 48–831.01. Findings and declaration of intent
§ 48–831.03. Establishment of AccessRx
§ 48–831.07. Operation of program
§ 48–831.08. Discrepancies in rebate amounts
§ 48–831.09. Action with regard to nonparticipating manufacturers and labelers
§ 48–831.11. Eligibility procedures
§ 48–831.12. Method of prescribing or ordering drugs
§ 48–831.13. Third-party administration
§ 48–831.15. Annual summary report
§ 48–831.16. Agreements with governments of other jurisdictions and other entities