Medically Necessary Early Refills (COVID-19 preparedness)
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Temporary relaxation of Alaska Medicaid pharmacy POS early refill edits to allow medically necessary early refills during COVID-19 preparedness for Alaska Medicaid members, affecting pharmacy providers and Magellan Clinical Call Center processes.
Early refill edit tolerances were relaxed for 30-day, 90-day, and 30-day opioid prescriptions to permit earlier refills during COVID-19 preparedness.
Medically Necessary Early Refill Criteria (COVID-19)
Medically necessary early refill criteria (COVID-19)
Alaska Medicaid will allow medically necessary early refills by relaxing POS edit parameters as follows.
Accumulation (on-hand) for non-opioid 30-day = 15 days
Accumulation (on-hand) for non-opioid 90-day = 21 days
Accumulation (on-hand) for opioid narcotics 30-day = 7 days
Exceptions
- Providers or pharmacies may request exceptions via the Magellan Clinical Call Center for situations outside these parameters (e.g., quarantine)
Magellan Clinical Call Center: 800.331.4475
Billing / Coding
| No codes listed |
Provider / Pharmacy Actions
Contact Magellan Clinical Call Center for early refill exceptions
Pharmacies must contact the Magellan Clinical Call Center at 800.331.4475 for member-specific situations requiring medically necessary early refills that fall outside the pharmacy point-of-sale system edit parameters (for example, quarantine or other circumstances necessitating additional on‑hand medication). The Call Center is prepared to receive phone calls from Pharmacy Providers to assist members during these evolving conditions.
- Use the Magellan Clinical Call Center for exceptions to the 2-week (30-day), 3-week (90-day), or 7-day (30-day opioid) on‑hand tolerances.
- Provide member-specific details so Magellan can evaluate and authorize exceptions as appropriate.
Definitions
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