Administrative Code

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Virginia Administrative Code
Title 12. Health
Agency 5. Department of Health
Chapter 195. Virginia WIC Program
7/15/2020

12VAC5-195-350. Price Verification.

A. Authorized retailers and applicants must submit prices for all mandatory foods and formulas as defined by the state agency. Once prices have been submitted to the WIC Program, they must remain in effect for at least a 30-day period and are subject to random onsite verification by the state agency. Posted prices that are significantly higher than the prices submitted to the state agency may affect the retailer's or applicant's authorization selection status.

B. A retailer or applicant's submitted price shall be compared by the state agency to other authorized retailer in the same peer group to determine if the prices submitted are competitive. Prices shall be submitted and validated as competitive for specific food items and formulas as specified in the retailer manual.

C. Authorized retailers and applicants shall have a pricing point value that is 40 or higher in order to remain eligible for program authorization.

Description

Price Comparison Range

Pricing Point Value

Best Pricing

Peer Group Average, minus 10% or more

100

Highly Competitive

Peer Group Average, minus 5.1 - 9.9%

80

More Competitive Pricing

Peer Group Pricing Average, plus or minus 5.0%

60

Competitive

Peer Group Pricing Average, plus 5.1 - 19.9%

40

Noncompetitive

Peer Group Pricing Average, plus 20% or higher

20

D. Authorized retailers whose prices are identified as noncompetitive when compared with other authorized retailers in the same peer group may have their WIC Program authorization terminated unless the state agency determines that inadequate participant access would exist if the retailer's authorization were terminated.

E. Authorized retailers that fail to submit a price for optional food and formula items may have redeemed food instruments selected as ineligible for payment as part of the post-payment review process. The improperly redeemed food instruments may be identified as a retailer claim and may be subject to repayment of the full amount paid for all of the items prescribed on the food instrument.

Statutory Authority

§ 32.1-12 of the Code of Virginia; 7 CFR Part 246.

Historical Notes

Derived from Volume 24, Issue 19, eff. May 26, 2008; amended, Virginia Register Volume 29, Issue 12, eff. March 13, 2013; Volume 35, Issue 22, eff. July 24, 2019.

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