Virginia Regulatory Town Hall
Department of Medical Assistance Services
Board of Medical Assistance Services
Methods and Standards for Establishing Payment Rate; Other Types of Care [12 VAC 30 ‑ 80]
CH 0080 Pharmacy Supplemental Rebate/Unit Dose Fee/Drug Threshold
Action 3637
General Information
Action Summary This action modifies the regulatory text for supplemental drug rebate agreements to make the agreement process easier and reduce paperwork. It removes the dispensing fee paid for unit dose drugs. It also removes the prior authorization requirement for noninstitutionalized and institutionalized individuals who use high numbers of legend drugs every month.
Chapters Affected
  VAC Chapter Name Action Type
Primary 12 VAC 30-80 Methods and Standards for Establishing Payment Rate; Other Types of Care Amend Existing Regulation
Other chapters
  12 VAC 30 - 50 Amount, Duration, and Scope of Medical and Remedial Care and Services
Executive Branch Review This action will go through the normal Executive Branch Review process.
RIS Project Yes  [003130]
Associated Mandates Eliminate Dispensing Fee for NF Unit Dose Drugs
New Periodic Review This action will not be used to conduct a new periodic review.
Stages associated with this regulatory action.
Stage ID Stage Type Status
6116 Fast-Track Stage complete. This regulation became effective on 01/16/2014.
Contact Information
Name / Title: Emily McClellan   / Regulatory Supervisor
Address: 600 E. Broad Street
Suite 1300
Richmond, VA 23219
Email Address:
Phone: (804)371-4300    FAX: (804)786-1680    TDD: ()-

This person is the primary contact for this chapter.