The governor of
Florida has issued a State of Emergency for the entire state due Tropical Storm
Erika.
Due to this issuance, Express
Scripts has implemented Emergency Refill Too Soon procedures in the state of
Florida for Part D and Medicare Advantage plans.
Effective immediately, if a
patient from the disaster area attempts to fill a prescription for lost or
damaged medication resulting from the disaster, and the claim rejects with a
NCPDP reject 79 (Refill Too Soon), the pharmacy should enter override code 91100000001
in NCPDP vD.0 field 462-EV “Prior Auth Number Submitted.”
This override code should be
used to process claims only for affected Part D and Medicare Advantage
members in the state of Florida through September 27, 2015.
Pharmacies should contact the Pharmacy Help Desk at 800.824.0898
or 800.922.1557 for additional assistance in overriding RTS rejects.
