Update on Issue with ADHD Preferred Meds Requiring PA
NCTracks is aware of an issue regarding pharmacy claims for the Antihyperkinesis class of medications. The preferred Antihyperkinesis agents DO NOT require prior approval. However, all of the claims for Antihyperkinesis agents (preferred and non-preferred) are rejecting for PHARMACY PA REQUIRED.
NCTracks is working towards a resolution as quickly as possible. An update will be posted when more information is available. We currently anticipate the issue being resolved by tomorrow morning, May 7th. (The system is expected to be down tonight from midnight to 12:30 a.m. to resolve the issue.)
In the meantime, the temporary fix is to have the pharmacy call the NCTracks Pharmacy PA Unit to request a 30-day override of the ADHD medication that is being rejected.
The other option is that a pharmacy can give the beneficiary a 72-hour emergency supply. Please Note: Since the 72-hour supply is for a C-II medication, the pharmacy will have to obtain a new prescription after the issue is resolved, or they can reverse the 72-hour supply claim and bill for the entire prescription quantity for the original prescription.
An update will be posted on the NCTracks Provider Portal and an email sent to providers when the issue is resolved. The Call Center is currently experiencing longer than normal hold times because of this issue. Until resolved, the Pharmacy PA Unit will assist with any urgent claim needs.