Medicaid Emergency Provider Information for Hurricane EvacueesThe Ohio Department of Jobs and Family Services has requested assistance from OPA in getting help for the thousands of refugees coming to Ohio from Alabama, Louisiana and Mississippi who are current Medicaid recipients in those states. Ohio pharmacies can now become providers on an emergency expedited basis in those states. The following information tells you how to get the forms and apply for provider status, and be paid at the rate applicable in that state. HOWEVER, the states specifically request that stores apply for provider status only after knowing that evacuees are residing in the area. They prefer that chain pharmacies only apply for individual pharmacies that will be serving these individuals, or the stateís ability to process provider applications will be overwhelmed! In other words, donít apply for provider status to show your support for the effort, but only do it if you have reason to believe that your pharmacy will be utilized. We have tried to give you the basic info on each of the programs, but contact info is included, if you need it. Ohio is working to expedite the processing of those evacuees who are not currently on Medicaid in their home state, but find themselves living here without income for some period of time. These states have indicated that they will make the provider status retroactive to August 29th for Alabama and Mississippi, and August 27th for Louisiana.
Thanks for helping these individuals. Please contact OPA if you have any questions at firstname.lastname@example.org or 614-586-1497.
Only 4 brand name medications are authorized per month
This information is directly from Alabama Medicaid Department:
AL has created an "abbreviated" out of state provider enrollment packet for pharmacies; this 4 page document can be found at our website: http://www.medicaid.state.al.us/documents/Billing/5-I_Provider.Enrollment/5-H-Out-of-State_Pharmacy_App_V1.0.pdf
*Pharmacy provider numbers obtained utilizing this application will be effective August 29, 2005. AL Medicaid reimburses at lower of: AWP-10%, WAC+9.2%, FUL, DOJ, or State MAC; plus $5.40 dispensing fee for retail. For complete billing and reimbursement information, Chapter 27, Pharmacy Services, of our Billing Manual can be found on our website:
*AL Medicaid pharmacy edits will continue for all recipients. AL Medicaid pharmacy edits include: Preferred Drug List, Four Brand Limit, Therapeutic Duplication, Maximum Units, Prior Authorization, etc. Information on all edits can be found on our website:
*Requests for prior authorization must be certified as medically necessary by the physician and submitted to Health Information Designs (HID) for approval. Only HID can issue prior authorizations (PAs). HID may be contacted at 1-800-748-0130.
Please do not hesitate to contact our Pharmacy Services at (334)242-5050 for more information. We thank all of you for your assistance during this time.
Kelli D. Littlejohn, R.Ph.
Director, Pharmacy Services
Alabama Medicaid Agency
Mary J. Terrebonne, Pharmacy Director, 1-225-342-1980; 800-437-9101;
Contact: Carol, E-mail: email@example.com
Judith Clark R.Ph, Pharmacy Director, 1-601-359-5253
ACS is the claims processor for the state, and can be reached at 866-759-4108, E-mail: firstname.lastname@example.org
Restrictions: Plan covers a maximum 34 day supply or 100 unit doses, whichever is greater, with 5 refills for all Rx. Birth control pills may be dispensed in 3 month quantities. Monthly limit of 5 Rx per participant, 2 additional are allowed with Prior Authorization.; Provider status retroactive to August 29
May 11, 2016
May 12, 2016
Makoy Center, 5462 Center Street, Hilliard, OH 43026
May 25, 2016
June 14, 2016
OPA office- 2674 Federated Blvd., Columbus, OH 43235