Harrisburg, PA - Governor Tom Wolf announced today that the Department of Human Services (DHS) has directed the state’s Medicaid Managed Care Organizations (MCOs) to let Medicaid recipients obtain early refills of all prescriptions at their pharmacy point-of-sale, which is especially important in light of 33 counties under stay-at-home orders. The MCOs are also being directed to be flexible with issuing prior authorizations for longer durations when medically necessary during the COVID-19 pandemic.
“In order to mitigate the spread of COVID-19 and follow the stay-at-home orders, we must all reduce trips and interactions with others in order to limit the chance of coming in contact with or spreading the COVID-19 virus,” Gov. Wolf said. “By asking Medicaid providers and pharmacists to allow for earlier prescription refills and longer prescription supplies, we are all doing our part to practice social distancing to keep everyone safe and well.”
“During these stay-at-home orders, we strongly encourage Medicaid recipients to use this option to reduce the need for unnecessary trips out of the home that may jeopardize their or someone else’s health,” DHS Sec. Teresa Miller said. “We appreciate our Medicaid providers and pharmacists’ participation in this initiative to help stop the spread of COVID-19.”
Pharmacies are essential-to-life services and will continue to operate during COVID-19 mitigation efforts, so Medicaid recipients are able to fill these prescriptions now if they have not yet. If the prescription is current and there are refills remaining on the prescription, the pharmacist would be able to issue early refills. If the prescription is out of refills, contact your health care provider for a new prescription.
This directive extends to both recipients covered by HealthChoices managed care organizations and fee-for-service Medicaid. Consumers may obtain early refills for opioids for pain management, but the prior authorization requirement based on day supply for short-acting opioids remains in effect.
Visit the PA Department of Health’s dedicated Coronavirus webpage for the most up-to-date information regarding COVID-19.
Guidance to DHS providers related to COVID-19 is available here.
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