Sec. 10.54.03.10. Food Package Prices After Authorization

A. After authorization, a vendor, other than a pharmacy only or military commissary, shall maintain prices for each of the food packages set forth in Regulation .06A of this chapter that are less than or equal to 125 percent of the peer group average for each food package.

B. Upon request of the State agency, a vendor, other than a pharmacy or military commissary, shall submit on the vendor price list form its lowest shelf prices for WIC-authorized foods to the State agency.

C. The State agency shall notify a vendor, other than a pharmacy only or a military commissary, that fails to submit its prices on the vendor price list form when requested to do so that, if the price list form is not received by the Program within 10 business days of the State agency’s request, the vendor’s authorization shall be terminated for 12 months from the date of disqualification.

D. If a vendor, other than a military commissary, submits prices on the vendor price list form that make its food package price more than 125 percent of the peer group average for that food package, or the food package prices are determined by the WIC Management Information System calculation to exceed 125 percent of the peer group average, the State agency shall notify the vendor that:

(1) Its price submission or food package price calculation is unacceptable;

(2) It shall lower its actual lowest shelf prices for the WIC foods and resubmit the vendor price list form to the State agency within 10 days following the notification; and

(3) If the vendor’s resubmitted prices indicate that a food package will cost the Program more than 125 percent of the peer group average for that food package, the State agency may disqualify the vendor for 12 months from the date of disqualification.

E. If, at any time, a vendor, other than a military commissary, has actual lowest shelf prices that make any food package price more than 125 percent of the peer group average, the State agency shall notify the vendor that:

(1) The vendor shall lower its actual lowest shelf prices for the WIC foods within 10 days; and

(2) If the vendor’s prices remain so that a food package will cost the Program more than 125 percent of the peer group average, the vendor’s authorization shall be terminated for 12 months from the date of disqualification.

F. If, in 2 consecutive reporting months, a vendor, other than a pharmacy only or a military commissary, is determined by the WIC Management Information System calculation to have food package prices that exceed 125 percent of the peer group average, the vendor’s authorization shall be terminated for 12 months from the date of disqualification.

G. The State agency may request that a vendor, other than a pharmacy only or a military commissary, submit semi-annual price lists at the State agency’s sole discretion and may use these price lists and the WIC Management Information System for calculation of excess charges if it is determined that excess charges have occurred.

H. For the purpose of cost containment, the State agency shall assign to an above 50 percent vendor peer group a vendor that is determined by the State agency, through a comparison of the vendor's gross annual sales, SNAP eligible sales, and WIC redemptions, to derive more than 50 percent of the vendor's eligible food sales revenue from the redemption of WIC food instruments.

I. A vendor that has been determined to derive more than 50 percent of its eligible food sales revenue from the redemption of WIC food instruments will only be paid at the statewide average of all other non-above 50 percent vendors.

J. For the purpose of cost containment, the State agency:

(1) Shall use the methodology provided by the U.S. Department of Agriculture, Food Nutrition Service to ascertain whether or not the vendor derives more than 50 percent of the vendor’s eligible food sales revenue from the redemption of WIC food instruments; and

(2) May reject information submitted by a vendor to demonstrate that it does not derive more than 50 percent of the vendor’s eligible food sales revenue from the redemption of WIC food instruments.