Welcome to the District of Columbia Medicaid Pharmacy Program website. Information and Member Login The May 15, 2020, Pharmacy and Therapeutics Committee Meeting will not be done as an in-person meeting due to COVID-19 concerns. The Department contracts with Change Healthcare to provide consultation and support for the Keystone State. Medicaid programs and Medicaid MCOs may manage the list of covered drugs through a Preferred Drug List (PDL) and/or prior authorization. Some of the features on CT.gov will not function properly with out javascript enabled. Your 2020 Formulary SignatureValue 3-Tier This formulary is accurate as of Jan. 1, 2020 and is subject to change after this date. Medicaid-covered drugs in therapeutic classes that are not included in the Statewide PDL remain covered drugs for beneficiaries. It is not an exclusive list of drugs covered by Medicaid and includes approximately 35% of all Medicaid covered drugs.
Last Published 04.29.2018. Less than 2% of Medicaid covered drugs that are not included on the Statewide PDL require clinical prior authorization in the FFS delivery system. The list of these drugs may be found on the department's Additional information regarding prior authorization of drugs not included on the Statewide PDL for beneficiaries who receive their pharmacy benefits from one of the HealthChoices or Community HealthChoices MCOs is available directly from each MCO. Dipeptidyl Peptidase-4 (DPP-4) Inhibitors (Michigan) Prior Authorization Form - Community Plan. The department's Pharmacy and Therapeutics (P&T) Committee, which is comprised of external physicians, pharmacists, consumer representatives, and voting members from each of the HealthChoices and Community Health Choices MCOs, recommends therapeutic classes to include on the PDL, preferred or non-preferred status for the drugs in each class, and corresponding prior authorization guidelines for each class. HUSKY Health offers coverage to eligible children, parents, relative caregivers, elders, individuals with disabilities, adults without dependent children, and pregnant women. Medicaid agencies must make payment for all Medicaid covered drugs when they are medically necessary.
Last Published 01.08.2020.
When drugs within a class are clinically equivalent, the committee considers the comparative cost-effectiveness of the drugs in the class. The prior authorization guidelines for drugs and drug classes included on the Statewide PDL apply to beneficiaries who receive their pharmacy benefits through the FFS delivery system and to beneficiaries who receive their pharmacy benefits through one of the HealthChoices/Community HealthChoices MCOs. Proudly founded in 1681 as a place of tolerance and freedom.You may be trying to access this site from a secured browser on the server. Medicaid agencies must make payment for all Medicaid covered drugs when they are medically necessary. Drugs that fall into a class on the Statewide PDL are generally designated as non-preferred until they are reviewed by the P&T committee. This formulary applies to members of our UnitedHealthcare West HMO medical plans with a …
It could be because it is not supported, or that JavaScript is intentionally disabled. Department of Vermont Health Access. 2020/08/03: MaineCare PDL (MEDEL Combined) with criteria- July 31, 2020 1.42 MB: 2020/08/03: For more documents, see archives page. These drugs remain available to Medicaid beneficiaries through the prior authorization process. The Kansas Medicaid PDL was authorized by K.S.A. It seems that JavaScript is not working in your browser. The department maintains Additional information regarding quantity limits for beneficiaries who receive their pharmacy benefits from one of the HealthChoices or Community HealthChoices MCOs is available directly from each MCO. FULL A formulary is a list of covered drugs. The quarterly P&T Committee meeting was held on June 19, 2020.
The Statewide PDL includes only a subset of all Medicaid covered drugs. Some preferred drugs on the Statewide PDL require a clinical prior authorization.
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