Division 121
Pharmaceutical Services

Foreword and Definition of Terms

Organizations Authorized to Provide Pharmaceutical Prescription Services

Practitioner-Managed Prescription Drug Plan

Supplemental Rebate Agreements

Polypharmacy Profiling

Prior Authorization Required for Drugs and Products

How to Get Prior Authorization for Drugs

Durable Medical Equipment, Medical Supplies, and Medical Surgical Services (Physician Administered Drugs)

Drug Use Review

Pharmacy and Therapeutics Committee

Pharmacy Management Program

Client Confidentiality

Prescription Requirements

Dispensing Limitations

Exclusions and Limitations

Dispensing in a Nursing Facility or Community Based Care Living Facility

Billing Requirements

Reimbursement

Participation in the Medicaid Drug Rebate Program

Dispensing Fees

Pharmacy Based Immunization Delivery

Medication Therapy Management Services and Clozapine Therapy Monitoring

Billing Forms

Instructions for Completion of the Prescription Drug Invoice

Billing Quantities, Metric Quantities and Package Sizes

CMS Federal Upper Limits for Drug Payments

DESI Less-Than-Effective Drug List

Oregon Medicaid and Pharmaceutical Manufacturers’ Dispute Resolution Procedures

Items Covered in the All-Inclusive Rate for Nursing Facilities