On June 17, the Department of Public Health and Human Services will hold a public hearing via remote conferencing to consider proposed amendments to Medicaid and non-Medicaid provider rates, fee schedules and effective dates. For pharmacy providers, the following are proposed changes to outpatient drugs reimbursement for both dispensing fees and vaccine administration fees.
(f) The outpatient drugs reimbursement dispensing fees range as provided in ARM 37.86.1105(3)(b) is effective July 1, 2023 July 1, 2024:
(i) for pharmacies with prescription volume between 0 and 39,999, the minimum is $5.11 $5.28, and the maximum is $16.36 $17.01;
(ii) for pharmacies with prescription volume between 40,000 and 69,999, the minimum is $5.11 $5.28, and the maximum is $14.16 $14.73; or
(iii) for pharmacies with prescription volume greater than or equal to 70,000, the minimum is $5.11 $5.28, and the maximum is $11.98 $12.46.
(g) remains the same.
(h) The outpatient drugs reimbursement vaccine administration fee, as provided in ARM 37.86.1105(6), will be $21.32 for the first vaccine and $18.65 $15.53 for each additional vaccine administered on the same date of service, effective July 1, 2023 July 1, 2024.
Concerned persons may submit their data, views or arguments either orally or in writing at the hearing. Written data, views or arguments may also be submitted to: Bailey Yuhas, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail hhsadminrules@mt.gov, and must be received no later than 5:00 pm on June 21.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.