No. 42291 (Amendment): Section R414-60-12. Provider-Administered Drugs for the Treatment of Opioid Use Disorders  

  • (Amendment)

    DAR File No.: 42291
    Filed: 11/01/2017 04:24:56 PM

    RULE ANALYSIS

    Purpose of the rule or reason for the change:

    The purpose of this change is to implement by rule a policy for the treatment of opioid treatment disorders.

    Summary of the rule or change:

    This amendment clarifies payment for pharmacies that dispense drugs directly to providers for the treatment of opioid use disorders. It also clarifies that only providers may receive and administer these drugs to their patients.

    Statutory or constitutional authorization for this rule:

    Anticipated cost or savings to:

    the state budget:

    There is no impact to the state budget because this change only clarifies pharmacy services and does not affect reimbursement.

    local governments:

    There is no impact to local governments because they do not fund pharmacy services under the Medicaid program.

    small businesses:

    Some pharmacies may incur expenses related to delivery of medications to providers. Nevertheless, these expenses are negligible and are offset by potential revenue.

    persons other than small businesses, businesses, or local governmental entities:

    There is no impact to Medicaid providers and to Medicaid members because this change only clarifies pharmacy services and does not affect reimbursement.

    Compliance costs for affected persons:

    There is no impact to a single Medicaid provider or to a Medicaid member because this change only clarifies pharmacy services and does not affect reimbursement.

    Comments by the department head on the fiscal impact the rule may have on businesses:

    After conducting a thorough analysis, it was determined that this proposed rule change will not result in a fiscal impact to businesses.

    Joseph K. Miner, MD, Executive Director

    The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

    Health
    Health Care Financing, Coverage and Reimbursement Policy
    CANNON HEALTH BLDG
    288 N 1460 W
    SALT LAKE CITY, UT 84116-3231

    Direct questions regarding this rule to:

    Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

    12/15/2017

    This rule may become effective on:

    01/01/2018

    Authorized by:

    Joseph Miner, Executive Director

    RULE TEXT

    R414. Health, Health Care Financing, Coverage and Reimbursement Policy.

    R414-60. Medicaid Policy for Pharmacy Program.

    R414-60-12. Provider-Administered Drugs for the Treatment of Opioid Use Disorders.

    A pharmacy may bill Medicaid for any covered, provider-administered drug not directly dispensed to a patient for the treatment of an opioid use disorder. The pharmacy may only release the drug to the administering provider or the provider's staff for treatment.

     

    KEY: Medicaid

    Date of Enactment or Last Substantive Amendment: [October 1], 2017

    Notice of Continuation: April 28, 2017

    Authorizing, and Implemented or Interpreted Law: 26-18-3; 26-1-5


Document Information

Effective Date:
1/1/2018
Publication Date:
11/15/2017
Type:
Notices of Proposed Rules
Filed Date:
11/01/2017
Agencies:
Health, Health Care Financing, Coverage and Reimbursement Policy
Rulemaking Authority:

Section 26-1-5

Section 26-18-3

Authorized By:
Joseph Miner, Executive Director
DAR File No.:
42291
Summary:

This amendment clarifies payment for pharmacies that dispense drugs directly to providers for the treatment of opioid use disorders. It also clarifies that only providers may receive and administer these drugs to their patients.

CodeNo:
R414-60-12
CodeName:
Provider-Administered Drugs for the Treatment of Opioid Use Disorders
Link Address:
HealthHealth Care Financing, Coverage and Reimbursement PolicyCANNON HEALTH BLDG288 N 1460 WSALT LAKE CITY, UT 84116-3231
Link Way:

Craig Devashrayee, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at cdevashrayee@utah.gov

AdditionalInfo:
More information about a Notice of Proposed Rule is available online. The Portable Document Format (PDF) version of the Bulletin is the official version. The PDF version of this issue is available at https://rules.utah.gov/publicat/bull_pdf/2017/b20171115.pdf. The HTML edition of the Bulletin is a convenience copy. Any discrepancy between the PDF version and HTML version is resolved in favor of the PDF version. Text to be deleted is struck through and surrounded by brackets ([example]). Text ...
Related Chapter/Rule NO.: (1)
R414-60-12. Provider-Administered Drugs for the Treatment of Opioid Use Disorders