MCO Pharmacy Lock-In Program Policy
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Defines MedImpact's role and contact information for managing Medicaid managed care organization (MCO) pharmacy lock‑in programs for Kentucky; describes responsibilities for MCOs and how providers can obtain assistance.
No material clinical or coverage changes in this revision.
Lock‑In Program Operational Criteria
Lock-in program operational criteria
Operational responsibilities and contacts for lock-in program administration and support.
MedImpact KY MCO support
- Program Questions: KYMCOPBM@MedImpact.com
- Pharmacy Help Desk: (800) 210-7628 (24/7)
- Prior Authorizations Phone: (844) 336-2676 (8:00AM - 7:00PM EST, 7 days/week); Fax: (858) 357-2612
- Pharmacy Portal: https://kyportal.medimpact.com/
- BIN: 023880 / PCN: KYPROD1 / GROUP: KYM01
MedImpact KY FFS support
- Program Questions: KYMFFS@MedImpact.com
- Pharmacy Help Desk: (877) 403-6034 (24/7)
- Prior Authorizations Phone: (877) 403-6034 (8:00AM - 7:00PM EST, 7 days/week); Fax: (858) 357-2612
- Pharmacy Portal: https://kyportal.medimpact.com/
- BIN: 026309 / PCN: KYPROD1 / GROUP: KYF01
Lock‑In Management and Provider Actions
Lock‑in management and provider action
MCOs are responsible for identifying, managing, and updating member lock‑in status and must provide member lock‑in/restriction files to MedImpact; pharmacy providers should consult the specific MCO lock‑in policy and contact the listed MCO contact for details or questions. If additional assistance or concerns remain, pharmacy providers may contact Quinlan Radcliff (quinlan.radcliff@ky.gov).
- MCOs provide member lock‑in files to MedImpact on an as‑needed basis and must send updated member restriction records when changes are necessary.
- Pharmacy providers should refer to the attached MCO lock‑in policies and use the MCO‑specific contact information listed in the policy for program questions and member services.
- Escalation contact: Quinlan Radcliff (quinlan.radcliff@ky.gov).
Key Definitions
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