Sec. 10.18.06.09. Cause for Suspension or Removal and Imposition of Sanctions

A. If the Department determines that a pharmacy or the pharmacy’s employee, or both, has failed to comply with federal or State laws and regulations, the Department may:

(1) Suspend the pharmacy from MADAP;

(2) Withhold payment to the pharmacy; or

(3) Both.

B. Removal of a pharmacy or a pharmacy’s employee from Medical Assistance shall result in removal from MADAP.

C. The Department:

(1) May consult with the State Board of Pharmacy regarding the actions of a pharmacy, such as:

(a) A breach of confidentiality;

(b) Refusal of service; or

(c) Discrimination; and

(2) Shall consider the findings and recommendations of the State Board of Pharmacy when deciding on the imposition of a sanction as stated in §A of this regulation.

D. The Department shall give the pharmacy written notice of the Department’s intention to impose sanctions referred to in §A of this regulation, including:

(1) The effective date of the proposed action;

(2) The reason for the proposed action; and

(3) The pharmacy’s right to appeal the proposed action.

E. A pharmacy voluntarily withdrawing from MADAP or removed or suspended from MADAP according to this regulation shall notify a recipient that the pharmacy is no longer a MADAP pharmacy.