Attention: Pharmacy Providers Prescriptions for Preferred Brands with Non-preferred Generic Alternatives

The solution which will reimburse pharmacy claims for brand preferred/generic non-preferred medications at brand NADAC cost basis regardless of the DAW code on the claim has been successfully implemented into NCTracks. Previously, only claims with DAW codes of 1 or 8 (or 7 for NTI drugs) were paid at the higher brand rate.

Pharmacy providers who submitted their claims for brand preferred/generic non-preferred medications without DAW codes equal to 1 or 8 may now resubmit their claims where underpayment occurred at that time.

In addition, pharmacy providers who submitted their claims for brand preferred/generic non-preferred medications with a DAW code equal to 1 or 8, but have concerns regarding the use of these DAW codes, may also resubmit their claims using more appropriate DAW codes.