Ohio Code 5167.243 – Quarterly reports
(A) The state pharmacy benefit manager shall provide to the medicaid director a written quarterly report containing the following information from the immediately preceding quarter:
Terms Used In Ohio Code 5167.243
- Care management system: means the system established under section 5167. See Ohio Code 5167.01
- Contract: A legal written agreement that becomes binding when signed.
- Medicaid managed care organization: means a managed care organization under contract with the department of medicaid pursuant to section 5167. See Ohio Code 5167.01
- state: means the state of Ohio. See Ohio Code 1.59
- State pharmacy benefit manager: means the pharmacy benefit manager selected by and under contract with the medicaid director under section 5167. See Ohio Code 5167.01
(1) The prices that the state pharmacy benefit manager negotiated for prescribed drugs under the care management system. The price must include any rebates the state pharmacy benefit manager received from the drug manufacturer;
(2) The prices the state pharmacy benefit manager paid to pharmacies for prescribed drugs;
(3) Any rebate amounts the state pharmacy benefit manager passed on to individual pharmacies;
(4) The percentage of savings in drug prices that are passed on to participants in the care management system;
(5) The information described in division (C) of section 5167.24 of the Revised Code;
(6) Any other information required by the director.
(B) The director may ask the state pharmacy benefit manager to provide additional information as necessary and shall collect other clinical data from the state pharmacy benefit manager as the director sees fit.
(C) At the time of contract execution, renewal, or modification, the department shall modify the reporting requirements under its medicaid managed care organization contracts as necessary to meet the requirements of this section.