2709. REIMBURSEMENT FOR BRAND NAME DRUGS

2709 REIMBURSEMENT FOR BRAND NAME DRUGS 2709.1 Reimbursement for brand name drugs shall include a professional dispensing fee in the amount of $11.15 and the lesser of: The pharmacies’ usual and customary charges to the general public; or The Actual Acquisition Cost (AAC), which shall be determined by DHCF in accordance with § 2709.2. 2709.2 The AAC shall be determined by DHCF based upon the lesser of: The NADAC when available, which shall be published online at https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing/index.html; or The WAC plus zero percent (0%), which shall be kept by drug file pricing compendia vendors or drug databases approved by and in use at the federal level. SOURCE: Final Rulemaking published at 59 DCR 2298, 2300 (March 23, 2012); as amended by Final Rulemaking published at 65 DCR 7837 (July 27, 2018). District of Columbia Municipal Regulations Public Welfare 29 DCMR § 2709