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Section 400.109l Process for Maximum Allowable Cost Pricing Reconsiderations; Use by Department of Community Health and Contracted Health Plans; Completion; Notification to Pharmacy.

MI Comp L § 400.109l (2019) (N/A)
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Sec. 109l.

The department of community health and contracted health plans shall utilize a process for maximum allowable cost pricing reconsiderations that must be available and provided to providers and pharmacists. This process must include identification of 3 national drug codes, if there are 3 or more available, and all available national drug codes, if there are fewer than 3, for the drug in question that are actually available and deliverable by a Michigan licensed wholesaler or a Michigan licensed manufacturer and would fall into the department of community health's or contracted health plans' maximum allowable cost pricing. The process must be completed in 10 business days, with all notification to the pharmacy in either written or electronic form. The department of community health and contracted health plans cannot be held accountable for failing to provide information for which they do not have access.

History: Add. 2014, Act 167, Eff. Mar. 31, 2015

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