|
Change Healthcare (a division of Optum) experienced a cyber-attack last Wednesday, February 21.
Change Healthcare provides many functions in the pharmacy space, including as the pharmacy benefits vendor for Wyoming Medicaid and other state Medicaid programs. As a result of the outage, Wyoming Medicaid pharmacy prior authorization requests and claims cannot be submitted or adjudicated.
Rest assured, this does not have implications for prior authorization requests or claims for medical services. Prescriptions will be filled without prior authorization during the outage. However, we urge you to examine the PDL (preferred drug list) on the Medicaid website
(https://health.wyo.gov/healthcarefin/medicaid/pharmacy-services/) to best navigate prior authorization criteria, especially with new prescriptions, to minimize the chance of a patient needing to switch to a preferred medication at their next fill.
Medicaid is guaranteeing retroactive payment to pharmacies once the system is restored and we are working on stop-gap measures for pharmacies that request it. Unfortunately, we have already heard reports of a few pharmacies not filling Medicaid prescriptions during the outage.
We are trying to minimize this occurrence, but you may have patients that need to use an alternate pharmacy. Please encourage patients to reach out to Wyoming Medicaid at 307-777-7531 for assistance if their pharmacy refuses to fill their prescription or demands that the patient pay cash.
Please do not hesitate to reach out with any questions or concerns.
Best,
Paul Johnson, MD
Wyoming Medicaid Director
| 
