Pharmacy Lock-in Program

AmeriHealth Caritas New Hampshire’s lock-in program assigns members to a specific pharmacy to monitor, prevent, and reduce the misuse of pharmacy services.

Lock-in notice

A multidisciplinary team reviews member medical and pharmacy utilization, as well as referrals by providers and the state. If the team finds evidence of misuse, abuse, or potential fraud of pharmacy services by a member, they will lock in the member and send notice to:

• The member.
• The pharmacy assigned to the lock-in member.

Each notice will detail the member’s lock-in assignment to a pharmacy.

Provider referrals

Providers can refer members to our lock-in program if they suspect misuse, abuse, or potential fraud of pharmacy services. If you suspect member fraud, misuse, or abuse of pharmacy services, you are encouraged to make a referral to the pharmacy lock-in program by calling the Fraud, Waste, and Abuse Hotline at 1-866-833-9718.