5160-9-12 Ohio department of medicaid (ODM) list of drugs covered without prior authorization.

 

 

 

PUBLIC HEARING NOTICE OHIO DEPARTMENT OF MEDICAID

 

DATE:                       December 30, 2013

TIME:                        1:00 p.m.

LOCATION:               Room C621, Lazarus Building

50 W Town St., Columbus, Ohio 43215

 

Pursuant to section 5164.02 and Chapter 119. of the Ohio Revised Code, the director of the Ohio Department of Medicaid (ODM) gives notice of the department's intent to consider the amendment of the rules as identified below and of a public hearing thereon.

 

Rule 5160-9-12, entitled "Ohio Department of Medicaid (ODM) list of drugs covered without prior authorization," is being proposed for amendment to update policy relating to the administration of the Medicaid pharmacy program. This rule sets forth the list of drugs covered without prior authorization by the Ohio Medicaid program. The rule body is being amended to update references to OAC rules that have been renumbered. The appendix of this rule is being changed to incorporate federal statutory changes in Section 175 of the Medicare Improvement for Patients And Providers Act of 2008 (MIPPA) relating to the administration of the Medicare Part D and Medicaid programs. These changes, which will take effect January 1, 2014, provide that states will not be able to obtain federal Medicaid funding for certain drugs when they are prescribed for consumers that are also eligible for Medicare, because the drugs will be covered by Medicare Part D. Changes have been made in the appendix to discontinue coverage of barbiturates for consumers dually eligible for Medicare and Medicaid, because they will be covered by Medicare Part D beginning January 1, 2014 and no longer eligible for federal matching funds to the Medicaid program. Other changes to the appendix are being made for routine maintenance of the drug list including addition of drugs new to the market; removal of drugs that have generic alternatives, drugs that are no longer marketed or that have been identified by the federal Centers for Medicare and Medicaid Services as non-payable; and changes to co-payment requirements.

 

A copy of the proposed rule is available, without charge, to any person affected by the rule at the address listed below and at the county departments of job and family services. The rules are also available on the internet at http://www.registerofohio.state.oh.us/. A public hearing on the proposed rules will be held at the date, time, and location listed at the top of this notice. Either written or oral testimony will be taken at the public hearing. Additionally, written comments submitted or postmarked no later than the date of the public hearing will be treated as testimony. Requests for a copy of the proposed rules or comments on the rules should be submitted by mail to the Ohio Department of Medicaid, Office of Legal Counsel, 50 W. Town St., Suite 400, Columbus, Ohio 43215, by fax at [phone], or by e-mail at [e-mail]. Comments received may be reviewed at this address.