Effective Dec. 27, 2016, Amerigroup changed its “Refills Allowed After” (i.e. Refill Too Soon) limits for members enrolled in its Medicaid and CHIP plans.
The changes to the Medicaid Refills Allowed After limits will require members to use 90% of a prescription before a refill can be obtained. Claims submitted before the 90% threshold has been reached will reject with NCPDP Reject 79, “Refill Too Soon.”
State specific plan processing information is listed in the attachment for your reference.