205.6316 Review of procedures for medical assistance reimbursement of
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/ky/205-6316A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
pharmacists to reduce fraud and abuse -- Dispensing fee. The Cabinet for Health and Family Services shall review the procedures for medical assistance reimbursement of pharmacists to reduce fraud and abuse. The cabinet shall by promulgation of administrative regulation, pursuant to KRS Chapter 13A, establish the following:
(1)Point-of-sale computer technology, with integration of data at the physician's office
and the pharmacy, that will permit prospective drug utilization review;
(2)Usage parameters by drug class to enable medical necessity and appropriateness
reviews to be conducted prior to payment;
(3)A dialog among the Department for Medicaid Services, the Kentucky Medical
Board of Licensure, and the Kentucky Board of Pharmacy, to develop
recommendations for legislation for the 1996 Regular Session of the General
Assembly that will strengthen the generic substitution laws for prescription
medication; and
(4)A dispensing fee for each prescription.