Reminder: Section 80, Pharmacy Services Update

August 23, 2012

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, MaineCare added these products back into the formulary and members are now able to get the medically necessary prescribed nutritionals at either a medical supply dealer or a retail pharmacy. MaineCare is currently working with the Women, Infants and Children (W.I.C.) program to develop a clear and coordinated plan that will assure that MaineCare members are able to receive the nutritional products they need.

If you have any questions about this message, please contact your Provider Relations Specialist.