§ 42-66.2.1-6. Administrative fees.
(a) The department of human services and the office of healthy aging shall ensure that
administrative fees imposed by means of subsection (b) or (c), are sufficient to cover
all expenses related to the management of the discount program, and shall periodically
revise any arrangements under this section in order to maximize enrollment and to
minimize the price paid by enrollees for prescriptions.
(b) Per-prescription administrative fees paid by the enrollee shall be established as
follows:
(1)for the first twenty thousand (20,000) prescriptions filled for program
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§ 42-66.2.1-6. Administrative fees.
(a) The department of human services and the office of healthy aging shall ensure that
administrative fees imposed by means of subsection (b) or (c), are sufficient to cover
all expenses related to the management of the discount program, and shall periodically
revise any arrangements under this section in order to maximize enrollment and to
minimize the price paid by enrollees for prescriptions.
(b) Per-prescription administrative fees paid by the enrollee shall be established as
follows: (1) for the first twenty thousand (20,000) prescriptions filled for program
beneficiaries, two dollars ($2.00) per prescription; (2) for the next twenty thousand
(20,000) prescriptions filled for program beneficiaries, one dollar and fifty cents
($1.50) per prescription; (3) for the next twenty thousand (20,000) prescriptions
filled for program beneficiaries, one dollar ($1.00) per prescription; (4) after the
initial sixty thousand (60,000) prescriptions are filled, the Rhode Island Best Rx
Program Advisory Commission, established in § 42-66.2.1-7, shall advise the department
of human services and the office of healthy aging regarding an appropriate per-prescription
administrative fee, which shall not exceed one dollar ($1.00) per prescription.
(c) Any authority for the contractor to retain a share of manufacturer rebates to defray
administrative expenses shall be subject to a quarterly review and revision based
on reconciliation of aggregate rebates received and administrative costs in excess
of fees established under subsection (b).
(d) The department of human services and the office of healthy aging shall seek to minimize
the diversion of rebates to pay administrative costs, and shall phase out all such
use of rebates as soon as feasible, in order to ensure that rebates are passed through
to enrollees for whom a drug is prescribed.
(e) Department of human services — Powers. The department of human services is authorized to promulgate rules and regulations
for the administration of this chapter and to further its purposes.