What happens if a PAC member needs a prescription refill for a drug that is not on the MCO’s formulary?
There is an interim policy to assure that PAC members get their medications during this transition period. This policy will be in effective for a 90 day period for those PAC members who were previously enrolled in MPAP and enroll in an MCO between July 1 – September 1, 2006. The MCOs are required to grandfather a one-time, temporary, 30 day fill or less, supply of non-formulary drugs. Prescriptions for each non-formulary drug must be honored once during the 90 day period. The policy does not apply to multiple fills of a non-formulary drug.
