Common use of Pharmacy Drug Claims Clause in Contracts

Pharmacy Drug Claims. 1.6.1 Pharmacy drug claims shall be processed in accordance with the guidelines in Chapter 8, Section 9.1; however, there will be no discount applied to pharmacy drugs. The DVA/VHA medical facility will bill for outpatient prescriptions and prescription refills written for each 30 day supply (or fraction thereof) at the DVA/VHA medical facility’s costs for the prescription items plus a reasonable fee to cover the DVA/VHA medical facility’s dispensing costs. The DVA/VHA medical facility shall be reimbursed based on: • The billed charge or, • The TRICARE allowable charge, whichever is less.