Ohio Code 5167.245 – Appeals process
Current as of: 2024 | Check for updates
|
Other versions
The medicaid director shall establish an appeals process by which pharmacies may appeal to the department of medicaid any disputes relating to the maximum allowable cost set by the state pharmacy benefit manager for a prescribed drug. All pharmacies participating in the care management system shall use the appeals process to resolve any disputes relating to the maximum allowable cost set by the state pharmacy benefit manager.
Terms Used In Ohio Code 5167.245
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- Care management system: means the system established under 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