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AN ACT relating to the Critical Access Care Pharmacy Program. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
ď˘SECTION 1. A NEW SECTION OF KRS CHAPTER 205 IS CREATED TO 3
READ AS FOLLOWS: 4
(1) As used in this section: 5
(a) "Critical access care pharmacy" means: 6
1. A Kentucky-based brick-and mortar-pharmacy; 7
2. Located in a county having fewer than fifty thousand (50,000) 8
residents according to the most recent federal decennial census; and 9
3. Whose owner owns fewer than ten (10) Kentucky-based brick-and-10
mortar pharmacies; 11
(b) "Critical Access Care Pharmacy Program payment" means a payment 12
based on the number of individual prescriptions a critical access care 13
pharmacy fills during a quarter multiplied by the lesser of the individual 14
payment amount or the dispensing reimbursement rate used by the 15
department under the Kentucky medical assistance program as of July 1 of 16
the same year; 17
(c) "Department" means the Department for Medicaid Services; and 18
(d) "Individual payment amount" means the quotient of twenty-five percent 19
(25%) of the annual amount appropriated for the Critical Access Care 20
Pharmacy Program divided by the number of prescriptions filled by all 21
critical access care pharmacies reimbursed by Medicaid managed care 22
organizations that quarter. 23
(2) As funds are available, the department shall establish a Critical Access Care 24
Pharmacy Program to ensure the sustainability of critical access pharmacies 25
throughout Kentucky. 26
(3) The Critical Access Care Pharmacy Program shall not exceed ten million dollars 27 UNOFFICIAL COPY 23 RS BR 1225
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($10,000,000) each fiscal year and individual payment amounts per prescription 1
shall not exceed the dispensing rate that the department would have reimbursed 2
under the Kentucky medical assistance program as of July 1 of the same year. 3
(4) (a) On a quarterly basis, the department shall determine the number of 4
prescriptions filled by critical access care pharmacies reimbursed by 5
Medicaid managed care organizations utilizing encounter data available to 6
the department. 7
(b) The department shall determine the individual payment amount per 8
prescription. 9
(c) If the individual payment amount per prescription in a quarter exceeds the 10
reimbursement rate under the Kentucky medical assistance program as of 11
July 1 of the same year, the individual payment amount per prescription 12
shall be the dispensing reimbursement rate under the medical assistance 13
program as of July 1 of the same year. 14
(5) On a quarterly basis, the department shall distribute to critical access care 15
pharmacies a Critical Access Care Pharmacy Program payment. The first 16
payment shall be calculated utilizing the encounter data from the last quarter of 17
state fiscal year 2022. 18
(6) The department may promulgate administrative regulations pursuant to KRS 19
Chapter 13A to implement the Critical Access Care Pharmacy Program. 20
(7) Any receipt of payment under this section shall not reduce or influence any other 21
payment a pharmacy may receive for services. 22