C.M.R. 10, 144, ch. 104, § 144-104-2, subsec. 144-104-2.12
The Department will pay a supplemental dispensing fee for prescriptions provided to members residing in rural areas in an attempt to assure continuing access to prescription services for these members. The rural dispensing fee will range from 55¢ to 65¢ per prescription dispensed to rural members, and will change on a quarterly basis to reflect the prior quarter's number of prescriptions filled. The Department will distribute the rural dispensing fee adjustment retrospectively on a quarterly basis. The Department will calculate the quarterly adjustment for each pharmacy by taking that quarter's total allotment and dividing the total allotment for the quarter by the number of prescriptions filled for rural members in the quarter. The Department will then group these by pharmacy and distribute in the quarter following. Pharmacies will be notified on a quarterly basis on the Department's designated website the amount of the adjustment for the quarter.
Rural members will be defined using a standard and federally recognized definition of rural using Metropolitan Statistical Area (MSA) designations. The Department will determine MSA/Non-MSA designation based on the zip code of the member's residence.
C.M.R. 10, 144, ch. 104, § 144-104-2, subsec. 144-104-2.12