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PRINTER'S NO. 2104
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1595
Session of
2017
INTRODUCED BY EVERETT, GROVE, IRVIN, O'NEILL, RADER, GODSHALL,
M. K. KELLER, BAKER, KAUFFMAN, LONGIETTI, SAYLOR, DAVIS,
BARRAR, CHARLTON, B. MILLER, JOZWIAK, TOEPEL, WARD,
HENNESSEY, FARRY, PICKETT, CORBIN, KORTZ, WHEELAND, DeLUCA,
PHILLIPS-HILL, NELSON, STAATS, KLUNK, MATZIE, McGINNIS,
SANTORA, MASSER, FEE, HICKERNELL AND REESE, JUNE 21, 2017
REFERRED TO COMMITTEE ON HEALTH, JUNE 21, 2017
AN ACT
Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
act to consolidate, editorially revise, and codify the public
welfare laws of the Commonwealth," in public assistance,
providing for medical assistance reimbursement for
pharmacies.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of June 13, 1967 (P.L.31, No.21), known
as the Human Services Code, is amended by adding a section to
read:
Section 450. Medical Assistance Reimbursement for
Pharmacies.--(a) For individuals receiving services under the
fee for service delivery system, the department shall reimburse
pharmacies as follows:
(1) If the NADAC per unit is available, the fee for service
payment shall be the lower of the following amounts:
(i) T he NADAC per unit with the addition of a professional
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dispensing fee of ten dollars and forty-nine cents ($10.49) per
prescription.
(ii) The pharmacy's usual and customary charge for the drug
dispensed.
(2) If the NADAC per unit is unavailable, the fee for
service payment shall be the lower of the following amounts:
(i) The wholesale acquisition cost with the addition of a
professional dispensing fee of ten dollars and forty-nine cents
($10.49) per prescription.
(ii) The pharmacy's usual and customary charge for the drug
dispensed.
(b) As used in this section, the following words and phrases
shall have the meanings given to them in this subsection unless
the context clearly indicates otherwise:
"NADAC per unit." The current National Average Drug
Acquisition Cost per unit.
Section 2. This act shall take effect in 60 days.
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