Drug Dispensing Policies

• No more than two (2) package sizes can be dispensed at one time if so prescribed.

• If a prescribed drug item is packaged by the manufacturer in more than one size and the prescriber DOES NOT specify which size is to be dispensed, the smallest standard size MUST be dispensed.

• Prescriptions written for a size NOT manufactured, the nearest smaller size must be dispensed.

• Quantities dispensed MUST be as ordered by the prescriber unless they are in excess of those allowable under the plan or by applicable law.

• If for some reason the quantity dispensed is less than originally ordered, the change MUST be noted on the prescription by the pharmacist along with the date, time and reason given.

• Suspect or altered prescriptions will not be honored for payment unless initialed by the prescriber at the point of ambiguity.

• Drugs prescribed may not exceed a thirty (30) day supply with the EXCEPTION of Maintenance Drugs which may be dispensed in supplies of up to ninety (90) if so prescribed.

• The electronic transmission or the transfer of prescriptions from one pharmacy to another must comply with the guidelines of the New York State Education Department. Electronic transmission of prescriptions must be in compliance with guidelines of all Federal and State regulating bodies and all relevant sections of the Participating Pharmacy Agreement.

• All telephoned prescriptions are to be reduced to writing and maintained in the pharmacy as required by law.

• No refills are allowed on diaphragms.

• Most injectable drugs are not covered through the member's pharmacy benefit. Self-administered injectables that are covered under the pharmacy benefit may require a prior approval before dispensing.

• There are selected items that are subject to review by HIP's Clinical Department prior to dispensing. After receiving a message "PA required", the pharmacy should call the Help Desk to convey the transaction information. The Pharmacy will receive a call back from the Help Desk after the review.

• Disposable insulin needles and syringes may be dispensed in the original package of one hundred (if prescribed), even if this quantity represents a one hundred day supply.

• For information concerning Mail Order, click here;

• Consult your HIP Welcome Kit or your Contract for further benefits, responsibilities, and restrictions.