Amendment to Tennessee Pharmacy Schedule Guidelines

Released: 07/31/2012   By: Abby Wright

The Tennessee Department of Workforce and Labor Development, Workers’ Compensation Division, has amended the current Pharmacy Schedule Guidelines to regulate the pricing of repackaged and compound medications. The new effective date for this amendment is listed as August 9, 2012.

Rule 0800-02-18-.12 Pharmacy Schedule Guidelines, section (1) is amended by adding a new subsection (h) at the end, which should read as follows:

(h) Repackaged or Compounded Products
All pharmaceutical bills submitted for repackaged or compounded products must include the NDC Number of the original manufacturer registered with the U.S. Food & Drug Administration or its authorized distributor’s stock package used in the repackaging or compounding process. The reimbursement allowed shall be based on the current published manufacturer’s AWP of the product or ingredient, calculated on a per unit basis, as of the date of dispensing. A repackaged or compounded NDC Number shall not be used and shall not be considered the original manufacturer’s NDC Number. If the original manufacturer’s NDC Number is not provided on the bill, then the reimbursement shall be based on the AWP of the lowest priced therapeutically equivalent drug, calculated on a per unit basis. The filling fees otherwise provided in these Rules shall be payable when applicable.

Authority: T.CA §§ 50-6-204, 50-6-205 and 50-6-233 (Rep!. 2005).

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