QACHCGettingAsthmaMeds

Getting Asthma Medication and Supplies for Children in HUSKY A

When a child needs prescription medication for several locations

(home, school, child care setting)

BlueCare Family Plan

· Provider writes one prescription with request that two be dispensed-one for each location where child will use the medication.

· Pharmacy will fill the prescription as written for up to a 30-day supply without additional approval from the health plan or pharmacy benefits vendor.

· If a member needs another supply before the current supply is finished due to inhalers stored in several

locations, providers must call for an override (Anthem Prescription Management 800-338-6180)

· Members with questions should call Anthem Customer Service (800 828-2239)

· Provider rewrites prescription after 6 months or when needed.

For additional information, call Elizabeth Malko MD, BlueCare Medical Director (203-985-7068 )

Community Health Network

· Provider writes separate prescriptions for each location, specifying on each prescription where the child will use the medication.

· Pharmacy will fill prescriptions for three or four 30-day

supplies at the same time without additional authorization or override from the health plan or pharmacy benefits vendor.

For additional information, call Beth Smith MD, Medical Director (203- 237-4000)

Health Net

· Provider writes one prescription that references all locations where the child will use the inhaler. The number of inhalers necessary is indicated on the prescription. Refills are authorized if desired by the physician.

· Pharmacy can fill up to a 60-day supply (based upon the physician directions) for these asthma inhalers without additional input from the plan or the pharmacy benefit vendor.

· Members should refill the prescription for the entire supply again after the 60-day supply is used. The system will allow for some overlap to refill early.

· The provider can request more by faxing a request to Health Net Pharmaceutical Services (800-977-8226) and indicating that the inhalers are needed for multiple locations.

· If a subsequent early refill is required due to one of the inhalers running out first at a particular location, pharmacies can call the Advance PCS Health Desk (877-747-9578) to request an early refill.

For additional information, call Health Net Customer Service (800-820-0210)

Preferred One

· Provider writes separate prescriptions for each location and specifies where child will use the medications.

· Pharmacy will fill prescriptions for 30-day supplies at the

same time without additional approval or override from the health plan or pharmacy benefits vendor.

For additional information, call Andrew Yuan MD, Medical Director (203-239-7444 ext.3114)

When a child needs dust mite barriers

BlueCare Family Plan

· To obtain prior authorization for dust mite barriers, contact BlueCare Family Plan Prior Authorization Department (800-828-2230 option #4).

For additional information, call Elizabeth Malko MD, BlueCare Medical Director (203-985-7068)

Community Health Network

· Provider writes prescription for dust mite barriers. Provider can call CHN Care Management (800-441-5071) if needed to find out which vendors stock the item.

· Provider calls in the prescription or family takes written prescription to vendor.

· Vendor will dispense or mail dust mite barriers to family (please specify).

For additional information, call Beth Smith MD, Medical Director (203- 237-4000)

Health Net

· Provider writes prescription and faxes to Silvers Drug Shop (203-933-1621 phone / 203-933-0014 fax)

· Pharmacy will ship dust mite barriers to family within 5-7 business days.

For additional information, call Health Net Customer Service (800-820-0210; ask for Provider Relations)

Preferred One

· Provider writes prescription for dust mite barriers and faxes to Asthma Case Manager (203-239-0016 fax) for authorization. Asthma case manager notifies a DME vendor about authorization.

OR

· Provider writes prescription and faxes it to vendor who then obtains authorization from Asthma Case Manager.

OR

· Member takes prescription to participating vendor that stocks dust mite barriers:

· Beirne's in Hamden (203-230-5050/203-230-5051 fax),

· People's Home Medical (203-230-3711/203-230-3716 fax)

· Kaye's (203-237-8997 x128 / 203-237-7354 fax)

· Vendor contacts family to arrange for pick-up or home delivery.

For additional information, call Andrew Yuan MD, Medical Director (203-239-7444 ext.3114)

Thanks to the Quality Assurance Subcommittee of the Medicaid Managed Care Council for assistance in developing this fact sheet.


When a child needs dust mite barriers

BlueCare Family Plan
· To obtain prior authorization for dust mite barriers, contact BlueCare Family Plan Prior Authorization Department (800-828-2230 option #4).	For additional information, call Elizabeth Malko MD, BlueCare Medical Director (203-985-7068)
Community Health Network
· Provider writes prescription for dust mite barriers. Provider can call CHN Care Management (800-441-5071) if needed to find out which vendors stock the item. · Provider calls in the prescription or family takes written prescription to vendor.	· Vendor will dispense or mail dust mite barriers to family (please specify). For additional information, call Beth Smith MD, Medical Director (203- 237-4000)
Health Net
· Provider writes prescription and faxes to Silvers Drug Shop (203-933-1621 phone / 203-933-0014 fax) · Pharmacy will ship dust mite barriers to family within 5-7 business days.	For additional information, call Health Net Customer Service (800-820-0210; ask for Provider Relations)
Preferred One
· Provider writes prescription for dust mite barriers and faxes to Asthma Case Manager (203-239-0016 fax) for authorization. Asthma case manager notifies a DME vendor about authorization. OR · Provider writes prescription and faxes it to vendor who then obtains authorization from Asthma Case Manager. OR · Member takes prescription to participating vendor that stocks dust mite barriers:	· Beirne's in Hamden (203-230-5050/203-230-5051 fax), · People's Home Medical (203-230-3711/203-230-3716 fax) · Kaye's (203-237-8997 x128 / 203-237-7354 fax) · Vendor contacts family to arrange for pick-up or home delivery. For additional information, call Andrew Yuan MD, Medical Director (203-239-7444 ext.3114)