Code of the District of Columbia

§ 48–831.07. Operation of program.

(a) Participating retail pharmacies shall submit claims to the Department to verify the amount charged to qualified residents and to receive reimbursement.

(b) The Department shall not impose transaction charges on participating retail pharmacies that submit claims or receive payments under AccessRx.

(c) On a periodic basis, to be established by the Department, the Department shall reimburse a participating retail pharmacy for:

(1) The discounted price provided to uninsured qualified residents pursuant to § 48-831.33; and

(2) Prescription drugs dispensed to low-income elderly pursuant to § 48-831.23.

(d) The Department shall conduct ongoing quality assurance activities similar to those used in the D.C. Medicaid program.

(e) The Department shall collect utilization data from participating retail pharmacies submitting claims necessary to calculate the amount of the rebate from the manufacturer or labeler. The Department shall protect the confidentiality of all information subject to confidentiality protection under District or federal law, rule or regulation.