Attn: Pharmacies & Durable Medical Equipment Providers

May 16, 2012

Section 80, Pharmacy Services Update

Emergency rules went into effect on April 1, 2012 which discontinued reimbursement for nutritional products at retail pharmacies. With this change, MaineCare would continue to reimburse for nutritional supplements if purchased at medical supply dealers when deemed medically necessary with prior authorization.

Some MaineCare families have experienced difficulty with this change and have not been able to access these services, when needed. Effective Friday, May 18, 2012, we will add these products back into the formulary so members are able to get the medically necessary prescribed nutritionals at either a medical supply dealer or a retail pharmacy. This will allow MaineCare time to develop a clear plan on products that are covered by MaineCare and where members are able to receive the nutritional products.