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  • Medicaid Provider Alert: Provider revalidation has begun and those not completing the process risk disenrollment.  Check your account now to learn when your revalidation is due. More information here.
Elizabeth M. Whitehorn, Director

Provider Notice issued 09/25/2024

 

To: Enrolled Pharmacies
​Date September 25, 2024
​Re:
 Critical Access Pharmacy (CAP) Quarterly Payments

The Department of Healthcare and Family Services (HFS) recently released 2023 Q4 and 2024 Q1 payments for the Critical Access Pharmacy (CAP) Program. Due to the Change Healthcare System outage earlier in the year, the Q4 data was not complete, and the Q1 data was estimated, and both will be reconciled as part of the 2024 Q2 payments once all the data from the Medicaid managed care plans has been submitted.

HFS made the estimated payments to ensure CAPs received these important funds. Please note that new pharmacies who have never received CAP funds had no estimated payment available for Q1, and therefore did not receive an initial CAP payment. HFS will also reconcile these pharmacy payments when the Q2 payments are processed.

If you have any questions regarding this notice, please contact a pharmacy billing consultant in the Bureau of Professional and Ancillary Services at 877-782-5565.

 

Kelly Cunningham, Administrator
Division of Medical Programs