Thank you Meri Waterhouse for sending out this information
Foster children and other children in out-of-home care each have Provider One cards, which means they are entitled to medical treatment and prescriptions through the Medicaid Program. If Medicaid rejects a prescription, and the pharmacist determines that the child has an urgent medical need, the pharmacy may provide an emergency supply of the medication. Pharmacists are authorized to give up to a 34-day emergency supply. Typically, a prescription can be rejected for safety reasons if the pharmacist believes a new drug for a child may could cause a bad interaction with other drugs being taken by the child. The Authority has informed pharmacies across the state about the emergency supply option. However, pharmacy staff may not know about or remember this policy.
If a medication is rejected at the pharmacy, please follow these instructions:
- Direct the pharmacy staff to Health Care Authority website information at: https://www.hca.wa.gov/assets/billers-and-providers/emergency_fill_policy.pdf
- Advise the pharmacy to contact Pharmacy Authorizations at (800) 562-3022, ext. 15483.
- During working hours (8 a.m. to 4:30 p.m. Monday through Friday), the caregiver may contact the Fostering Well-Being Care Coordination Unit at (800) 422-3263.
Remember, as a foster parent or caregiver, NEVER pay for any medical services, treatment, equipment or medications out of your own pocket. There are two reasons for this. When caregivers pay for items Medicaid should cover, it can be very expensive for you. It also could be dangerous for the child. Medicaid has special approvals in place to ensure the safety of children who are prescribed medications that treat mental health conditions. When these medications are paid for outside of Medicaid, a child could be prescribed medications that interact in a dangerous way with one another and they will not show up in the child’s Medicaid record.
Reference: https://www.hca.wa.gov/assets/billers-and-providers/emergency_fill_policy.pdf