23 Miss. Code. R. 214-1.1

Current through December 10, 2024

Rule 23-214-1.1 - Provider Enrollment and Pharmacy Participation

A. Pharmacists must comply with the requirements set forth in Part 200, Chapter 4, Rule 4.8 for all providers in addition to the provider type specific requirements that follow:

1. National Provider Identifier (NPI), verification from National Plan and Provider Enumeration System (NPPES),

2. Written confirmation from the IRS confirming the tax identification number and legal business name, and

3. Copy of current pharmacy permit issued by the Mississippi Board of Pharmacy.

B. Pharmacies participating in the Mississippi Medicaid program must:

1. Have a MS Board of Pharmacy permit for one of the following specified types of pharmacies:

a) Retail pharmacy must hold a community pharmacy permit,

b) Closed-door pharmacy must hold a specialty community pharmacy permit, and

c) Institutional pharmacy must hold an Institutional I or Institutional II pharmacy permit.

2. Be physically located within the state of Mississippi or within a thirty (30) mile radius of the state borders except if the servicing pharmacy provider is:

a) Providing drugs to a Mississippi Medicaid beneficiary who is a resident of a nursing facility, intermediate care facility for individuals with intellectual disabilities (ICF/IID) or psychiatric residential treatment facility (PRTF) or receiving specialized care that is located outside of the thirty (30) mile radius, or

b) The source of a drug not obtainable from any pharmacy provider within the state of Mississippi within the thirty (30) mile radius.

C. The Division of Medicaid reimburses pharmacy providers only for prescriptions that are received:

1. Via hand delivery by a beneficiary or his/her representative,

2. Directly via phone, fax, mail or other electronic means such as e-mail or electronic prescribing from a prescribing provider licensed under State law or an agent with medical training under the health professional's direct supervision. [Refer to Miss. Admin. Code, Part 214, Chapter 1, Rule 1.6.]

D. For Change of Ownership Liability refer to Miss. Admin. Code Part 200, Chapter 4, Rule 4.3.

23 Miss. Code. R. 214-1.1

Miss. Code Ann. §§ 43-13-121, 73-21-105, 73-21-106.