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MedicaidAdministrativeMedium impact

Medicaid lifts prescription limits in response to State of Emergency

Mississippi Medicaid (DOM)·MS · Pharmacy·Pharmacy
Effective date
Not stated
We identified it
Jun 21, 2026
Days to comply

Summary

Medicaid has temporarily lifted prescription quantity limits during officially declared states of emergency. Pharmacy providers can now override the standard 2 brand/6 prescription limit and early refill restrictions by entering '13-Payor Recognized Emergency' in NCPDP Field '420-DK'.

Action Required

Action needed
During officially declared emergencies: Pharmacy billing team must enter '13-Payor Recognized Emergency' in NCPDP Field '420-DK' when overriding prescription limits or early refill restrictions. Maintain documentation on file to justify early/excess fills for patients not in evacuation areas, as Medicaid may conduct post-emergency audits and recoup payments without proper documentation.