Important Information Regarding Pharmacy Co-Pays
Effective July 6, 2014 through October 31, 2014, pharmacies will not charge a co-pay to any Medicaid enrollee, including those enrolled with the Medicaid Care Management Organizations: Well Sense Health Plan, New Hampshire Healthy Families and Meridian Health Plan.
Medicaid enrollees with questions or concerns should call the DHHS Medicaid Client Services Unit toll free at 1-800-852-3345 X4344 or 603-271-4344. Pharmacy providers should call the appropriate provider relations number below with questions.
PUBLIC NOTICE RE: PHARMACY CO-PAYS
Effective August 15, 2014 health benefit coverage for the NH Health Protection Plan Program (NHHPP) will begin. One of the features of the legislation authorizing this program is a change in pharmacy co-pays that is based upon the individual client's federal poverty level (FPL). In the future, pharmacy co-pays will apply to individuals who are above 100% FPL only. Medicaid and NHHPP enrollees under 100% FPL will not be subject to the co-pay provisions. In order to implement the changes, DHHS must first complete eligibility and claims payment systems modifications that will allow DHHS, the Medicaid Care Management managed care organizations and pharmacy benefit managers to identify the clients who will not be subject to a pharmacy co-pay in the current Medicaid program (Fee For Service and Medicaid Managed Care) and the NHHPP, as well as identifying the clients that will be subject to pharmacy co-pays going forward. The system modifications to accurately and automatically identify those clients who are and are not subject to pharmacy co-pays will be ready November 1, 2014. While these systems are being built, pharmacy co-pays will not be applied to any Medicaid or NHHPP client. Effective July 6, 2014 through October 31, 2014, pharmacies will not charge a co-pay to any Medicaid client. Comments regarding this notice are due by August 5, 2104, and should be emailed to Diane Peterson at: [email protected] or to the Department of Health and Human Services, Office of Medicaid Business and Policy, Legal and Policy Unit, 129 Pleasant Street - Thayer Building, Concord, NH 03301-3857, Att: Diane Peterson.
Appeared in: The Union Leader on Thursday, 07/03/2014