Elderly Pharmaceutical Insurance Coverage Program Provider Bulletin
- Bulletin also available in Portable Document Format (PDF)
March 2024
Attention Pharmacy Providers: Discontinue Drugs Coverage
The New York State EPIC Program will discontinue coverage of drugs manufactured by Viiv Healthcare for claims submitted with a date-of-service that is on or after March 31, 2024, because the manufacturer has withdrawn from EPIC Manufacturers Rebate Program. New York State legislation requires manufacturer participation in the rebate program for EPIC to cover its products.
EPIC will discontinue coverage of all drugs manufactured under the following Viiv Healthcare-owned labeler codes.
Labeler Code Labeler Name 49702 Viiv Healthcare
Drugs under the above Labeler codes will receive the following rejection code:
NCPDP FIELD 511-FB REJECT CODE = 70 – Product/Service Not Covered
EPIC members using Viiv Healthcare products have been notified these drugs will no longer be covered by EPIC as of March 31, 2024. They have been advised to contact their prescriber for alternative drugs, or they can pay the full out-of-pocket Medicare Part D cost of Viiv Healthcare products if they choose to continue using them.
We appreciate your cooperation in this matter and your continued support of the EPIC program. If you have any questions, please call the EPIC Provider Helpline at 1-800-634-1340.
