Physician-Administered Drugs (J Codes) Reimbursement Changes
Notice of an Emergency Rule was published in the March 31, 2010 Indiana Register which will affect physician-administered drugs, aka, J codes. The Office of Medicaid Policy and Planning (OMPP) is proposing to modify the reimbursement for physician-administered drugs by basing the rates on 105 percent of the published wholesale acquisition cost (WAC) of the benchmark National Drug Code (NDC). If no WAC is available, other pricing metrics may be used as determined by the office. This change shall be effective May 1, 2010.
Now, just exactly what 105% of the WAC of the benchmark NDC is we are not sure. The notice states that the proposed pricing is available on the Myers & Stauffer website at (http://in.mslc.com). However, we have been unable to locate the proposed rate file. We will continue to monitor this emergency rule change proposal and provide additional details as they become available.
