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ask an expert
Kelly Makay

Kelly MaKay, RPh, MBA
Senior Health Plan Services Consultant

Q

Due to the COVID-19 pandemic, can we make decisions to lift a “refill-to-soon” restriction on a case by-case basis until we decide whether we want to lift such edits across the board?

 

A 

We do not recommend this. Rather, we recommend the Plan apply such changes uniformly to similarly situated enrollees who are affected by the disaster or emergency. Since COVID-19 has been declared a national emergency, this means if the Plan elects to lift such restrictions, they should be uniformly lifted across all enrollees.