OAR 431-121-2005
General Administration

(1)

The Administrator, or designee, may:

(a)

Negotiate price discounts and rebates on prescription drugs with prescription drug manufacturers and GPOs;

(b)

Purchase prescription drugs on behalf of participating programs;

(c)

Contract with a PDCP or PBM to adjudicate pharmacy claims and transmit program prices to pharmacies;

(d)

Determine program prices and reimburse or replenish pharmacies for prescription drugs dispensed or transferred;

(e)

Adopt and implement a PDL for the OPDP;

(f)

Develop a system for allocating and distributing the operational costs of the program and any rebates obtained to participating programs; and

(g)

Cooperate with any state or regional consortia in bulk purchasing of prescription drugs.

(2)

The Administrator or designated entity shall oversee the implementation of the OPDP, including review of member eligibility information, participating program information, and pharmacy provider compliance with program requirements. The Administrator, or designated entity, shall review records or other information, including health information, necessary to perform oversight responsibilities.

(3)

The Administrator shall establish processes, terms, and conditions describing how the entities identified in ORS 414.312 (Oregon Prescription Drug Program)(4) may participate in the OPDP as a participating program, including entities otherwise subject to ORS 731.036 (Persons completely exempt from application of Insurance Code)(6).

(4)

The Administrator or designated entity may contract with a PBM and directly or indirectly with pharmacy providers as the Administrator or designated entity considers necessary to maintain statewide access for OPDP members including consideration for CAP providers.

(5)

The Administrator or designated entity may contract with replenishment administrators, GPO’s, 340B providers, and pharmacy providers as necessary to utilize discount purchasing programs.

(6)

Annually, no later than November 1, the Office of Rural Health shall determine any Oregon pharmacies that meet CAP status and report them to the OPDP for CAP designation. OPDP shall send the current list of all Oregon retail pharmacies to the Office of Rural Health no later than October l each year.

Source: Rule 431-121-2005 — General Administration, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=431-121-2005.

Last Updated

Jun. 8, 2021

Rule 431-121-2005’s source at or​.us