June 1, 2007
Effective June 5, 2007:
· PACE will mandate substitution on Ambien®. Providers filling Ambien® prescriptions that are written “Brand Medically Necessary” and who have an Ambien® claim denied may contact PACE Provider Services for a one (1) time Medical Exception. Prescribers will be contacted by the Program to document the medical necessity for the cardholder to receive brand Ambien®.
· Claims for DESI drugs will deny with a NCPDP error of “88”, PACE “706” accompanied by the Call Help Desk (CH) response. Claims for DESI drugs must have “Medically Necessary” on the prescription and will only be accepted using the medical exception process.
Questions should be directed to Provider Services at: