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24.29.1416    APPLICABILITY OF DATE OF INJURY, DATE OF SERVICE

(1) The amounts of the following types of payments are determined according to the specific department rates in effect on the date the medical service is provided, regardless of the date of injury:

(a) medical fees; and

(b) hospital charges.

(2) The reimbursement rate for prescription drugs is based upon the rate in effect on the date the drug is dispensed. The rate for a specific generic-name drug is the average wholesale price of that drug plus a reasonable dispensing fee established by the insurer. If the generic drug is unavailable and the pharmacist so certifies under 39-71-727 , MCA, the reimbursement rate is the average wholesale price of the brand-name drug plus the dispensing fee.

(3) Department rates (fee schedules) do not apply to preferred providers or managed care organizations to the extent that they are rendering services or providing goods to workers who are covered by insurers with which they have a contract.

(4) Pursuant to statute, a pharmacist may not dispense more than a 30 days supply at any one time.

 

History: 39-71-203, MCA; IMP, 39-71-704 and 39-71-727, MCA; NEW, 1991 MAR p. 2622, Eff. 12/27/91; AMD, 1994 MAR p. 679, Eff. 4/1/94.

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