It is NACDS’ understanding that pharmacy claims for the updated Pfizer-BioNTech and Moderna COVID-19 vaccines have been rejecting under the pharmacy benefit through MedImpact. The Kentucky Pharmacy Association shared with us that Medicaid has decided to cover the new vaccines under the pharmacy benefit. MedImpact is working on system edits to accommodate pharmacy billing and will notify pharmacies when it is implemented. Additionally, managed care coverage will begin for the Abrysvo (Pfizer) and Arexvy (GSK) RSV vaccines effective October 6. For more information on Medicaid vaccine coverage, please see the updated version of MedImpact’s Vaccine Coverage Expansion.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.