OAR 431-121-2020
Program Price


(1)

The price for a prescription drug a pharmacy provider may charge a member under the OPDP is the lesser of the following on the date of the transaction:

(a)

The program price, or

(b)

The pharmacy provider’s usual and customary price, including program cost and dispensing fee.

(2)

The designated entity shall transmit the price of the prescription drugs to the pharmacy providers electronically.

(3)

The OPDP is limited to prescription drugs prescribed in the name of and for the use by the member, except as otherwise provided in section (7) of this rule.

(4)

Prescription drug benefit access shall be available on member identification cards.

(5)

The OPDP does not include prescriptions for over-the-counter drugs.

(6)

The Administrator, or designated entity, may establish different program prices for CAP providers in rural areas to maintain statewide access to the OPDP.

(7)

Unique pricing arrangements may be agreed upon between pharmacy providers and designated entity to accommodate group purchasing or 340B pricing for qualified entities.
Last Updated

Jun. 8, 2021

Rule 431-121-2020’s source at or​.us