DMAP administrative rules and supplemental information for:
Pharmaceutical services program
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Pharmaceutical Services program updates by e-mail
Rulebook
January 1, 2012 (pdf) (Administrative rules - 410-121-0000 through 410-121-0625)
Attention: Rules filed after January 1, 2012 have not been included in the Rulebook. Rules filed after January 1, 2012 are listed below:
- March 16, 2012 – 410-121-0030 Practitioner-Managed Prescription Drug Plan, OAR 410-121-0033 Polypharmacy profiling, 410-121-0040 Prior Authorization Required for Drugs and Products, 410-121-0100 Drug Use Review and 410-121-0110 Drug Use Review/Pharmacy & Therapeutics Committee
- May 20, 2012 – 410-121-0040 Prior Authorization Required for Drugs and Products
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Supplemental information
Pharmaceutical Services Supplemental Information (pdf) - Updated 9/27/11 - Eligibility and coverage information; billing guidelines for professional and pharmaceutical services, including Medication Therapy Management (MTM); Point of Sale, ProDUR and prior authorization information; 340B program information; contact information; related forms and resources.
Allowable National Drug Codes (NDCs) for billing diabetic supplies - Effective 8/1/11. For more information about upcoming changes to diabetic supply billing, read this letter (pdf).
Oregon Medicaid Pharmacy Quick Reference (pdf) - Updated 10/6/11 - Telephone numbers, e-mail addresses, Web links, quick facts about billing Oregon Medicaid, and after-hours contact information for managed care prescriptions.
Frequently asked questions about DMAP prescription coverage (link) - Updated 7/29/11.
NCPDP D.0 updates
- Point of sale - Refer to the NCPDP D.0 Payer Sheet - New! Effective 1/1/2012
- Paper claims - Even though the D.0 Universal Claim Form is now available, please continue to use the 5.1 version of this form until further notice. When DMAP is ready to accept the D.0 version, we will let you know.
- Recent announcements - EDI Bulletin 24, External Code List update, NCPDP D.0 Readiness
Other pharmacy (non-Medicaid) administrative rules
These non-Medicaid pharmacy rules are administered by other divisions. We have placed them here for your convenience to find all pharmacy-related rules together in one place. Click on each program for details:
Oregon Prescription Drug Program administrative rules
Oregon Prescription Drug Monitoring Program administrative rules
CAREAssist administrative rules
Who to call for help
- Provider Services 800-336-6016 or e-mail us
- Oregon Pharmacy Call Center 888-202-2126
- Address and telephone contacts