Issue - Inappropriate Denial of Preferred Sedative Hypnotics for PA
Sedative Hypnotics, Triptans, Zolpimist, and Vusion require a prior approval (PA) under certain conditions. However, as of November 4, 2014, the NCTracks system is incorrectly evaluating the PA requirement on some claims for these drugs, resulting in inappropriate denials. This issue is expected to be fixed and deployed into production on November 16, 2014, at which point providers can rebill the denied claims.