Exception Process Exists for New Medical Assistance Prescription Limit

The Pennsylvania Medical Society (PAMED) has heard from physicians who are concerned about the new Medical Assistance (MA) pharmacy benefit change that limits adult recipients to six prescriptions per month. Physicians say they are worried about their patients who take more than the new monthly limit, which went into effect Jan. 3, 2012.

There is an exception form for physicians to complete on behalf of their MA patients who exceed six prescriptions a month. In order to approve an exception, the Pennsylvania Department of Public Welfare (DPW) must determine that one of the following criteria is being met:

  • The recipient has a serious chronic systemic illness or other serious health condition and denial of the exception will jeopardize the life of the recipient or will result in the rapid, serious deterioration of his or her health.
  • Granting a specific exception is a cost-effective alternative.
  • Granting an exception is necessary in order to comply with federal law.

DPW also has published a list of medications that are automatic benefit limit exceptions, such as cancer and diabetes medications.

Some additional highlights of the pharmacy benefits package change include:

  • It only applies to those recipients who: are age 21 or older;   are not pregnant or in the 60-day postpartum period; or who do not reside in a nursing home or immediate care facility.
  • It does apply to those 21 or older who reside in personal care homes, domiciliary care homes, and assisted living facilities, as well as adult recipients enrolled in home and community-based waiver programs.
  • The appropriate managed care organization (MCO) has the ability to impose the same or lesser limits for pharmacy services. Those who choose to make these changes must notify network providers 30 days in advance.
  • Pharmacists have the discretion to dispense a five-day emergency supply that will not go against the six-prescription limit.
  • Regardless of whether the enrollee’s medication falls under the exception process or not, all current prior authorization requirements still apply.
  • MA recipients have the right to appeal the benefit limit exception request within 30 days of denial.

For more information, read DPW’s MA Bulletin published on Dec. 31, 2011.

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Comments: 4


I use more than six perscriptions per month. I was denied 3 medications by my pharmacy. They picked which ones to exclude. I can not get my antidepressants, my estrogen (I have had a hysterectomy)and I can not get my lancets that are diabetes testing supplies. Apperently only diabetes medication is covered by an exception but testing supplies are not. This is a shame, I know so many people that need their medications. What are you supposed to do when you have multiple diseases and health issues? If I do not test I can die. I was forced to stop taking my antidepressants which I have been on for ten years. If I do not take my estrogen I run a higher risk of heart disease, osteoporosis, etc. How can they do this to people.

Sad and confused at 2/11/2012 8:55:18 AM


Is this a way to get rid of a lot of patients permanently? I know people who are mentally ill who will not know how to go about getting their meds and will simply stop taking them when they are no longer available to pick up as usual and others that feel they will have to pick and choose which ones they take and which ones they will not be able to get easily. They may not follow the guide lines on getting what they need and will just give up. Who will take responsibility for these illnesses and deaths? I take more than six meds a day and I am wondering how I am going to be able to get all the ones that I need. Now, I just learned that I have and autoimmune disease and will need yet another prescription. Am I going to be able to get the ones I need. I have heart disease, fibromyalgia, arthritis, and sarcoidosis. I am scared for all of us who do not have an insurance company behind us. Just medicare or medicaid.

anonymous at 2/7/2012 8:44:57 PM


We'd be interested in hearing more about your difficulties. Could you contact us at jmblouch@pamedsoc.org.

PA Medical Society at 1/26/2012 4:21:22 PM


We have found this process to be extremely burdensome on our physicians and staff. We are a not-for-profit multi-specialty office that does not limit it's MA patients, but with the increase in time required we are considering capping the number of MA patients that we take on.

anonymous at 1/26/2012 8:43:53 AM

Last Updated: 1/9/2012
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