Elderly Pharmaceutical Insurance Coverage Program Provider Bulletin
- Bulletin also available in Portable Document Format (PDF)
June 2025
Attention Pharmacy Providers: Discontinue Drugs Coverage
The New York State EPIC Program will discontinue coverage of drugs manufactured by Merck for claims submitted with a date-of-service that is on or after July 30, 2025, because the manufacturer has withdrawn from EPIC Manufacturers Rebate Program.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 Merck-owned labeler codes.
| Labeler Code | Labeler Name |
|---|---|
| 00006 | Merck Sharp & DOHME LLC |
| 00052 | Merck Sharp & DOHME LLC |
| 00085 | Merck Sharp & DOHME LLC |
| 66582 | Merck Sharp & DOHME LLC |
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 Merck products have been notified these drugs will no longer be covered by EPIC as of July 30, 2025. 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 Merck 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.
