N.J. Admin. Code § 10:167A-1.10

Current through Register Vol. 57, No. 1, January 6, 2025

Section 10:167A-1.10 - PAAD program copayment

(a) Beneficiaries in the PAAD program are responsible for a part of the cost of drugs and devices covered by the PAAD program. At the point of sale, a PAAD beneficiary shall render to a pharmacy provider a fixed or adjustable copayment of an amount determined appropriate by the Legislature (see N.J.A.C. 10:167A-1.21(a)4 ).

(b) A copayment shall be rendered to a pharmacy provider for each original or refill prescription dispensed. The provider's usual and customary charge billed to the PAAD program shall be inclusive of the copayment amount which will be deducted by the New Jersey Medicaid Management Information System (NJMMIS).

1. Under no circumstances is the required rendered copayment amount to be waived for reasons of promotion, advertisement and/or competitive considerations. Failure to comply with PAAD program copayment requirements may result in a suspension of a provider's approval to participate in the PAAD program.

N.J. Admin. Code § 10:167A-1.10

Amended by R.1997 d.252, effective 6/16/1997.
See: 28 N.J.R. 2481(a), 28 N.J.R. 3221(a), 29 N.J.R. 2678(a).
Amended by R.1998 d.464, effective 9/8/1998.
See: 30 N.J.R. 2197(a), 30 N.J.R. 3309(a).
Recodified from N.J.A.C. 8:83C-1.8 and amended by R.2003 d. 248, effective 6/16/2003.
See: 34 N.J.R. 3456(a), 35 N.J.R. 2642(a).

Amended by 49 N.J.R. 446(a), effective 3/6/2017