RXBIN: 004336

RXPCN: ADV

RXGRP: RX0794

The Hernandez Settlement guidelines apply to Medicaid Enrollees in the State of Florida. The Florida Agency for Healthcare Administration (AHCA) requires that all participating pharmacy locations be in compliance with the Hernandez Settlement Agreement (HSA). An HSA non-compliance situation arises when a Medicaid Health Maintenance Organization (HMO) Enrollee is unable to get his or her prescription filled due to:

*Please see attached for more information*