MedicaidDocumentationHigh impact
Billing of Hemophilia Clotting Factors
Maryland Medicaid·MD · Pharmacy, Hematology·Pharmacy
Effective date
Apr 1, 2004
We identified it
Jun 20, 2026
Summary
Maryland Medicaid now requires specialty pharmacies to submit extensive documentation for hemophilia clotting factor prescriptions, including standard invoices, signed prescription copies, administration records, and pharmacy purchase invoices. Claims must be submitted online first, will automatically deny for preauthorization, then require manual faxing of documents for review and pricing.
Action Required
By April 1, 2004: Pharmacy staff must implement new billing workflow for hemophilia clotting factors: 1) Submit claims online through POS system, 2) When claim denies with preauth required message, fax required documentation (Standard Invoice, signed prescription copy, Administration Record, pharmacy purchase invoice) to 410-333-5398 or mail to OOE PO Box 2158 Baltimore MD 21203, 3) Maintain 6-month administration records signed by dispensing pharmacist, 4) Ensure pricing section is completed and signed by authorized pharmacy representative. Claims without proper documentation will be returned unpaid.