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Code of Federal Regulations Title 42. Public Health § 42.447.520 Federal Financial Participation (FFP):  Conditions relating to physician-administered drugs

Current as of October 02, 2022 | Updated by FindLaw Staff

(a) No FFP is available for physician-administered drugs for which a State has not required the submission of claims using codes that identify the drugs sufficiently for the State to bill a manufacturer for rebates.

(1) As of January 1, 2006, a State must require providers to submit claims for single source, physician-administered drugs using Healthcare Common Procedure Coding System codes or NDC numbers to secure rebates.

(2) As of January 1, 2007, a State must require providers to submit claims for physician-administered single source drugs and the 20 multiple source drugs identified by the Secretary using NDC numbers.

(b) As of January 1, 2008, a State must require providers to submit claims for the 20 multiple source physician-administered drugs identified by the Secretary as having the highest dollar value under the Medicaid Program using NDC numbers to secure rebates.

(c) A State that requires additional time to comply with the requirements of this section may apply to the Secretary for an extension.

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Cite this article: FindLaw.com - Code of Federal Regulations Title 42. Public Health § 42.447.520 Federal Financial Participation (FFP):  Conditions relating to physician-administered drugs - last updated October 02, 2022 | https://codes.findlaw.com/cfr/title-42-public-health/cfr-sect-42-447-520/

Read this complete Code of Federal Regulations Title 42. Public Health § 42.447.520 Federal Financial Participation (FFP):  Conditions relating to physician-administered drugs on Westlaw

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