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Current as of January 01, 2025 | Updated by Findlaw Staff
(1) The Department for Medicaid Services or a managed care organization contracted to provide services pursuant to this chapter shall provide a program for synchronization of medications when it is agreed among the member, a provider, and a pharmacist that synchronization of multiple prescriptions for the treatment of a chronic illness is in the best interest of the patient for the management or treatment of a chronic illness provided that the medications:
(a) Are covered by the Department for Medicaid Services or a managed care organization contracted to provide services pursuant to this chapter;
(b) Are used for treatment and management of chronic conditions that are subject to refills;
(c) Are not a Schedule II controlled substance or a Schedule III controlled substance containing hydrocodone;
(d) Meet all prior authorization criteria specific to the medications at the time of the synchronization request;
(e) Are of a formulation that can be effectively split over required short fill periods to achieve synchronization; and
(f) Do not have quantity limits or dose optimization criteria or requirements that would be violated in fulfilling synchronization.
(2) When applicable to permit synchronization, the Department for Medicaid Services or a managed care organization contracted to provide services pursuant to this chapter shall apply a prorated daily cost-sharing rate to any medication dispensed by a network pharmacy pursuant to this section.
(3) Any dispensing fee shall not be prorated and shall be based on an individual prescription filled or refilled.
Cite this article: FindLaw.com - Kentucky Revised Statutes Title XVII. Economic Security and Public Welfare § 205.529.Synchronization of multiple prescriptions for treatment of a chronic illness - last updated January 01, 2025 | https://codes.findlaw.com/ky/title-xvii-economic-security-and-public-welfare/ky-rev-st-sect-205-529/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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