Agencies
Services
Provider Notice issued 9/12/14
Contraceptives
Anticonvulsants (when prescribed for seizure disorder)
Albuterol inhaler (when prescribed for asthma or COPD)
Immunosuppressive agents (when prescribed for transplant patients)
Insulin (vial only)
Antipsychotics (when prescribed for schizophrenia)
Chapter P-200, Handbook for Providers of Pharmacy Services Lost, Stolen, or Destroyed Medications and Vacation Supplies of Medications
| To: | Enrolled Pharmacies |
| Date: | September 12, 2014 |
| Re: | Chapter P-200, Handbook for Providers of Pharmacy Services Lost, Stolen, or Destroyed Medications and Vacation Supplies of Medications |
The department will not cover lost, stolen, or destroyed over the counter (OTC) medication for any participant. The department will not cover lost, stolen, or destroyed prescription medications for adults with the exception of the list below.
For children through the age of 20, the department will grant approval for lost, stolen, or destroyed medications no more than once a year (one single approval per 365 day period, not one approval per prescription).
Exception List: (applies to adults and children)
Refill-Too-Soon (RTS) overrides for lost, stolen, or destroyed medications can be requested by a pharmacy or a prescriber’s office, with the exception of override requests for controlled substances. Overrides for controlled substances, with the exception of anticonvulsants when prescribed for seizure disorder, must be requested by the prescriber. Presentation of a new prescription from the prescriber at the pharmacy will meet the requirement of a request by the prescriber for controlled substances. If the request is for medication that was stolen, a police report number must be submitted with the request for RTS.
Vacation Supply of Medications
The department does not cover vacation supplies of medications for adults. Vacation supplies for children through age 20 are reviewed on a case-by-case basis. A vacation supply is a supply for an extended period of time while the participant is out of the state/country.
The Handbook for Providers of Pharmacy Services (pdf) has been updated and is available on the department’s Web site. Any questions regarding this bulletin should be directed to your facility’s medical assistance consultant in the Bureau of Professional and Ancillary Services at 1-877-782-5565.
Instructions for updating the Handbook for Providers of Pharmacy Services:
P-204.1 Refill-Too-Soon - Remove page HFS P-204 (1-2) and insert new page HFS P-204(1-2).