MedicaidPrior AuthHigh impact
New Medicaid Pharmacy Point of Sale (POS) System
Maryland Medicaid·MD · Pharmacy·Pharmacy
Effective date
Jan 4, 1999
We identified it
Jun 20, 2026
Summary
Maryland implemented a new Medicaid Pharmacy Point-of-Sale system with First Health Services Corporation effective January 4, 1999, introducing enhanced prior authorization requirements, third party liability enforcement, and diagnosis verification requirements for specific medications including H2 blockers and proton pump inhibitors.
Action Required
By April 23, 1999 (60 days from transmittal): Pharmacies must verify proper diagnosis documentation on prescriptions for H2 blockers and proton pump inhibitors used beyond 68 days of acute dose therapy. Enter '8' in PA/MC field when diagnosis is verified. For third party liability claims, submit TPL indicator codes (1-4) based on other insurance status. Update billing procedures to handle drug-drug interaction denials with appropriate intervention and outcome codes. For compounded prescriptions over $12, use NDC of most expensive ingredient with compound code '2'.