Please see the attached PDF with important information regarding OptumRx: Crowell & Moring LLP.

Please see the attached PDF with important information regarding OptumRx: Walbro.

Effective Date: 1/10/2017 to 1/11/2017

Multiple Plans under the UHEALTH Rx submitted group

Reject 50 – Participating Pharmacy Not Established

OptumRx has identified some claims were denying in error from 1/10/2017 to 1/11/2017. The error has since been corrected. Please reprocess any claims that rejected for Reason Code 50 – Participating Pharmacy Not Established.

Pharmacy,

You are receiving this notice as a reminder of the proper usage for Submission Clarification Code (SCC) 42.

SCC 42 use should be reserved for providing clarification on the reason the pharmacy is overriding a claim rejection. This should be done based on evidence obtained for validating the Prescriber ID submitted as active and valid on the Date of Service. Routine use of SCC 42 without a rejection is considered non-compliant with established protocol.

Molina Healthcare of Florida Molina appreciates your continued support in the health of our members. Medication adherence is extremely important in getting our members to better health. Molina Healthcare of Florida members should NOT be enrolled in any Automatic Refill Program as Automatic Refill dispensing is prohibited by Florida Medicaid. Per RULE: 59G-4.250: Prescribed Drug Services: Each fill (original or refill) must be specifically requested by the member prior to the dispensing of such medication(s). Dispensing scheduled automatic refills without such request is prohibited. Members should not sign waivers that in any way would circumvent the above stated rule.