Medicaid, Chargebacks, and Geodon DAW 2

Medicaid Chargebacks; Theft?

Medicaid Chargebacks; Theft?

A doctor wrote a script for Geodon but did not specify brand medically necessary.

The patient has requested brand and has been on brand for some time.

Script is run under Medicaid with a DAW 2.

Someone mentioned that there would be a charge back on this claim because they do not accepte DAW 2.

There is NO reject on the claim, no notification that DAW 2 is not accepted.

I called Medicaid and she said no they don't take DAW 2.

I said then should'nt the responsibility rely on you and therefore reject the claim or change the co-pay?

As a Pharmacy Technician we deal with so many insurance companies on a daily basis.

How could we possibly keep up with all the differnt rules on coverage?

It changes constantly. I think insurance companies need to be held accountable for what they want and not willingly deceive Pharmacies.

How can they legally charge back on this?

Shouldn't it reject the claim? Or at least tell us what is acceptable at the time of submitting the claim?

It has been my experience that Medicaid pays for brand half the time instead of generic.

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