diff --git a/programs/patient-data-resolver.service.js b/programs/patient-data-resolver.service.js
index 5bb7fa37f..8a04056cc 100755
--- a/programs/patient-data-resolver.service.js
+++ b/programs/patient-data-resolver.service.js
@@ -119,7 +119,10 @@ function checkTransferOut(patientUuid, params) {
 }
 
 function getMedicationRefillVisits(patientUuid) {
-  const expectedAdultReturnEncounter = '8d5b2be0-c2cc-11de-8d13-0010c6dffd0f';
+  const expectedEncounters = [
+    '8d5b2be0-c2cc-11de-8d13-0010c6dffd0f',
+    '4e7553b4-373d-452f-bc89-3f4ad9a01ce7'
+  ];
 
   const patientEncounters = encounterService.getPatientEncounters({
     patientUuid,
@@ -134,7 +137,7 @@ function getMedicationRefillVisits(patientUuid) {
           .filter(
             (encounter) =>
               encounter.encounterType &&
-              encounter.encounterType.uuid === expectedAdultReturnEncounter
+              expectedEncounters.includes(encounter.encounterType.uuid)
           )
           .sort(
             (a, b) =>
diff --git a/programs/patient-program-config.json b/programs/patient-program-config.json
index 5c25e815d..93955e2cc 100755
--- a/programs/patient-program-config.json
+++ b/programs/patient-program-config.json
@@ -736,8 +736,8 @@
       },
       {
         "uuid": "a2a265dc-508d-4f31-94ee-0bf8a58049d7",
-        "name": "HCW-Peer Delivery Visit",
-        "allowedIf": "!isEligibleForCommunityVisit",
+        "name": "HCW/Peer Delivery Visit",
+        "allowedIf": "!isEligibleForCommunityVisit && !isFirstAMPATHHIVVisit",
         "encounterTypes": [
           {
             "uuid": "987009c6-6f24-43f7-9640-c285d6553c63",
@@ -2980,8 +2980,8 @@
     "visitTypes": [
       {
         "uuid": "0becf5b9-0522-47c8-960c-c9d660c56501",
-        "name": "Facilty Medication Delivery Visit",
-        "allowedIf": "qualifiesMedicationRefillVisit && isEligibleForMedicationRefill",
+        "name": "Facility Medication Refill Visit",
+        "allowedIf": "programLocation === intendedVisitLocationUuid && qualifiesMedicationRefillVisit && isEligibleForMedicationRefill",
         "message": "Patient has to be in the location he enrolled into the HIV Care and Treatment program ",
         "encounterTypes": [
           {
@@ -3309,7 +3309,7 @@
       {
         "uuid": "3c1906a1-6d85-4184-9a43-0912cbac3d74",
         "name": "Community Medication Delivery Visit",
-        "allowedIf": "qualifiesMedicationRefillVisit && isEligibleForCommunityVisit",
+        "allowedIf": "programLocation === intendedVisitLocationUuid && qualifiesMedicationRefillVisit && isEligibleForCommunityVisit",
         "message": "Patient has to be in the location he enrolled into the HIV Care and Treatment program ",
         "encounterTypes": [
           {
@@ -3320,8 +3320,8 @@
       },
       {
         "uuid": "a2a265dc-508d-4f31-94ee-0bf8a58049d7",
-        "name": "HCW-Peer Delivery Visit",
-        "allowedIf": "!isEligibleForCommunityVisit",
+        "name": "HCW/Peer Delivery Visit",
+        "allowedIf": "!isEligibleForCommunityVisit && !isFirstAMPATHHIVVisit",
         "encounterTypes": [
           {
             "uuid": "987009c6-6f24-43f7-9640-c285d6553c63",
diff --git a/programs/scope-builder.service.js b/programs/scope-builder.service.js
index 1c0b1b287..a11505f5b 100755
--- a/programs/scope-builder.service.js
+++ b/programs/scope-builder.service.js
@@ -431,15 +431,21 @@ function validateMedicationRefillEligibility(validateMedicationRefill) {
 
   const icadAnswerUuid = '7e5e7759-e9f7-4b16-b904-041fcdddb390';
 
+  // Version 2.0 cutoff date
+  const VERSION_2_CUTOFF_DATE = new Date('2025-05-02');
+
   let isEligibleForMedicationRefill = false;
   let isEligibleForCommunityVisit = false;
+  let hasMedicationRefillConcept = false;
 
+  // Check if the new concepts exist in observations
   for (const obs of validateMedicationRefill.obs) {
     const conceptUuid = obs.concept?.uuid;
 
     if (!conceptUuid) continue;
 
     if (conceptUuid === conceptMap.medicationRefillEligibility) {
+      hasMedicationRefillConcept = true;
       isEligibleForMedicationRefill = true;
     }
 
@@ -451,9 +457,34 @@ function validateMedicationRefillEligibility(validateMedicationRefill) {
     }
   }
 
+  // Backwards compatibility logic for medicationRefillEligibility
+  if (!hasMedicationRefillConcept) {
+    const encounterDate = new Date(validateMedicationRefill.encounterDatetime);
+
+    // For encounters before version 2.0, default to eligible for medication refill
+    // This maintains the previous workflow where this validation didn't exist
+    if (encounterDate < VERSION_2_CUTOFF_DATE) {
+      isEligibleForMedicationRefill = true;
+      console.log(
+        'Legacy encounter detected - defaulting medicationRefill eligibility to true'
+      );
+    }
+    // For newer encounters without the concept
+    else {
+      console.warn(
+        'Recent encounter missing medicationRefillEligibility concept'
+      );
+      isEligibleForMedicationRefill = false;
+    }
+  }
+
   return {
     medicationRefill: isEligibleForMedicationRefill,
-    communityVisit: isEligibleForCommunityVisit
+    communityVisit: isEligibleForCommunityVisit,
+    isLegacyEncounter:
+      !hasMedicationRefillConcept &&
+      new Date(validateMedicationRefill.encounterDatetime) <
+        VERSION_2_CUTOFF_DATE
   };
 }