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HCA has identified an eligibility issue for client’s who should be enrolled in a Managed Care Organization, but have been incorrectly enrolled in a Medicare Savings Program. After this issue has been corrected in the ProviderOne system, eligibility will show as active and enrolled with an MCO plan in the ProviderOne system. However, the MCO system or the MCO’s Prescription Drug Manager (PBM) will still show the client as enrolled with Medicare.
If pharmacies encounter this issue, verify client’s eligibility in ProviderOne and contact the client’s MCO to have the client’s eligibility updated or issue an emergency fill until the issue is resolved.
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