Reminder: Controlled Substance Claims Denied for Prescribers Not Enrolled in Kentucky Medicaid
Effective November 8, 2010, prescriptions for controlled substances written by prescribers not enrolled in Kentucky Medicaid now deny at the point of sale and return the message: “Out of Network Prescriber: Prescriber Call 877-838-5085.”
e following prescriptions for controlled substances will be exempt from this edit:
Behavioral health related medications;
Medications used to treat pain related to cancer or HIV/AIDS; and
Medications for members younger than 19 years of age.
Pharmacy Action Needed: Call the PerformRx Help Desk at (800) 578-0898 to receive an override for an emergency three (3) day supply of controlled substances if the medication does not fall into the exempt category.
Provider Action Needed: If you or any providers in your practice are not currently enrolled in Kentucky Medicaid, the Plan strongly encourages you to do so by contacting the Kentucky Department for Medicaid Services (DMS) Provider Enrollment at (877) 838-5085 (Monday to Friday, 8 a.m. to 4:30 p.m.). You may also download an application for participation (MAP-811) on the DMS web site at http://www.chfs.ky.gov/dms/provEnr/. Please note, the process may take up to 90 days.
Questions: If you have questions about this communication, please contact the PHP Pharmacy department at (502) 585-8249.
Minimizing the Risk for Drug-Drug Interactions
Drug interactions are an important contributor to increased emergency room visits and hospital admissions1. Here are a few simple strategies to decrease the risk of drug-drug interactions, and a list of drug combinations to avoid. (Note: is is not a comprehensive listing.)
Tips to Decrease Drug-Drug Interactions
Take a complete medication history.
Be aware of members at risk for drug interactions:
On two or more medications; and/or
Taking anticonvulsants, antibiotics, digoxin, warfarin, and amiodarone.
Review drug information references to ensure you are not prescribing interacting medications.
Consult a pharmacist. Pharmacists are great resources to ensure proper medication therapy for our members.
If clinically appropriate, consider an alternative medication.
If medication is clinically necessary, closely monitor the patient for signs and symptoms of a drug-drug interaction.
Use the lowest dose possible.
Educate the member.