mids1999
06-08-2006, 08:40 PM
Can someone please explain this in simpler terms and how does this associate to me as a type 1 diabetic?
I just got approved for Pennsylvania Medical Assistance.
Also please tell me what a legend drug is?
http://www.hrsa.gov/reimbursement/states/Pennsylvania-Medicaid-Covered-Services.htm
From above linked page
Prescription Drugs
The MA Program covers legend drugs except as where specified as well as certain nonlegend drugs if medical necessity has been established and the service has been prescribed or ordered by a licensed prescriber within the scope of the prescriber’s practice.
The licensed prescriber certifies that a specific brand is medically necessary by doing all of the following:
· Writes on the prescription form ‘‘Brand Necessary’’ or ‘‘Brand Medically Necessary’’ in the prescriber’s own handwriting.
· Receives prior authorization from the Department to use the brand name product and writes the prior authorization number on the prescription form.
Payment for prescriptions is limited to quantities consistent with the medical needs of the patient not to exceed a 34-day supply or 100 units, whichever is greater.
I just got approved for Pennsylvania Medical Assistance.
Also please tell me what a legend drug is?
http://www.hrsa.gov/reimbursement/states/Pennsylvania-Medicaid-Covered-Services.htm
From above linked page
Prescription Drugs
The MA Program covers legend drugs except as where specified as well as certain nonlegend drugs if medical necessity has been established and the service has been prescribed or ordered by a licensed prescriber within the scope of the prescriber’s practice.
The licensed prescriber certifies that a specific brand is medically necessary by doing all of the following:
· Writes on the prescription form ‘‘Brand Necessary’’ or ‘‘Brand Medically Necessary’’ in the prescriber’s own handwriting.
· Receives prior authorization from the Department to use the brand name product and writes the prior authorization number on the prescription form.
Payment for prescriptions is limited to quantities consistent with the medical needs of the patient not to exceed a 34-day supply or 100 units, whichever is greater.