Prescription Drug Coverage Denials

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

RULE NO.: RULE TITLE:

59G-4.255 Prescription Drug Coverage Denials

NOTICE OF CHANGE

Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 31, No. 26, July 1, 2005 issue of the Florida Administrative Weekly, and Notice of Change published in Vol. 31, No. 52, December 30, 2005 issue of the Florida Administrative Weekly. These changes were in response to written comments received prior to the public hearing and from comments received from the Joint Administrative Procedures Committee.

The rule incorporates by reference the two signs: Important Notice to Medicaid Recipients and Aviso Importante a Recipientes de Medicaid. The date 5/14/2004 was added to the signs. The Notice of Change published on December 30, 2005, erroneously stated the date that was added to the signs was 5/14/2003. The correct date is 5/14/2004. The date in the rule text was corrected to read 5/14/2004, and we added the date after the names of both the English and Spanish signs.

The rule text was corrected as follows:

59G-4.255 Prescription Drug Coverage Denials.

(2) Medicaid-participating pharmacies shall post two signs, Important Notice to Medicaid Recipients, 5/14/2004, and Aviso Importante a Recipientes de Medicaid, 5/14/2004, which are incorporated by reference, in a conspicuous location that is visible to recipients. The signs inform recipients of a toll-free number that can be called if the prescription is denied and the pharmacy failed to provide the denial information and an Important Information About Your Florida Medicaid Prescription Drug Benefits or Información Importante A cerca de sus beneficios de medicamentos con receta del Medicaid de la Florida pamphlet to the recipient. The signs are available from the Agency for Health Care Administration’s website at http://ahca.myflorida.com/Medicaid/Prescribed_ Drug/multi_source.shtml.