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Pharmacy Claims Guidance For Refill Too Soon Rejections Related To Hurricane Beryl
On Monday, July 8, Hurricane Beryl made landfall on the Texas coast and caused significant damage and flooding in numerous counties, forcing many to evacuate to temporary locations. HHSC will allow pharmacies to override prescription claims [ [link removed] ] rejected with error codes 79 (Refill Too Soon) or 76 (Plan Limitations Exceeded) for people enrolled in fee-for-service Medicaid, the Children with Special Health Care Needs Services Program, and the Kidney Health Care Program that pharmacies identify as affected by Hurricane Beryl.
For people enrolled in Medicaid managed care or CHIP, pharmacies should contact the person's managed care organization for instruction. Refer to the MCO Search [ [link removed] ] for each MCO's contact information and billing codes.
Pharmacies can call the Texas Medicaid Pharmacy and Technical Call Center at 800-435-4165, Monday through Friday from 7 a.m. to 7 p.m. (central time) to request the override.
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