Medicaid Formulary (Drug List) 2020.A formulary is a list of covered drugs.The Medicaid formulary is a useful reference to assist practitioners in selecting clinically appropriate and cost-effective drug therapies.Medicaid Formulary Updates. You may still be able to get drugs not on the Preferred Drug List. Our lock-in program assigns members to a specific pharmacy and prescriber provider. Nebraska Medicaid program PDL. This list is updated regularly. This complete list of prescription drugs covered by your plan is current as of September 1, 2019. SPECIAL BULLETIN COVID-19 #25: Emergency Update to NC Medicaid and NC Health Choice Preferred Drug List (PDL) and REMS Program Flexibilities, https://medicaid.ncdhhs.gov/documents/preferred-drug-list, https://www.fda.gov/media/136317/download, albuterol HFA inhaler (generic for Proair® HFA Inhaler / Proventil® HFA Inhaler / Ventolin® HFA Inhaler), levalbuterol HFA inhaler (generic for Xopenex® HFA Inhaler). South Carolina Medicaid Comprehensive Preferred Drug List (List of Covered Drugs) WellCare of South Carolina 00 Please read: This document contains information about the drugs we cover in this plan. This is a list of drugs covered by your plan. DIFFERIN 0.3% GEL PUMP (TOPICAL) (DX CODE REQ.) In addition, there are medications and/or classes of medications that are not reviewed by the committee. Blue Cross NC’s prior review, restricted-access, non-formulary exceptions and North Carolina Division of Health Benefits North Carolina Medicaid and Health Choice Preferred Drug List (PDL) Effective: September 1, 2020 T. Preferred Non-Preferred. January 2020 North Carolina State Health Plan Preferred Drug List - Traditional Pharmacy Benefit. ALISKIREN/VALSARTAN (VALTURNA)* CIPROFLOXACIN 0.3%/DEXAMETHASONE 0.1% (CIPRODEX) ELBASVIR/GRAZOPREVIR (ZEPATIER)* NEOMYCIN/POLYMIXIN/HC SOLN/SUSP (CORTISPORIN) SOFOSBUVIR/VELPATASVIR (EPCLUSA)*. Telephone. Drug Plan. 1 0 obj Please visit https://www.fda.gov/media/136317/download for the current recommendations. cefdinir cap/susp (generic for Omnicef cap/susp®) cefditoren (generic for Spectracef®) cefixime cap/susp (generic for Suprax®) cefpodoxime (generic for Vantin®) Suprax chew/tab®. North Dakota Department of Human Services. The Ohio Department of Medicaid is implementing a Unified Preferred Drug List (UPDL) on January 1st, 2020 that will encompass the entire Medicaid population regardless of enrollment in Managed Care or Fee for Service (FFS). Brand name drug: Uppercase in bold type . cefdinir cap/susp (generic for Omnicef cap/susp®) cefditoren (generic for Spectracef®) cefixime cap/susp (generic for Suprax®) cefpodoxime (generic for Vantin®) Suprax chew/tab®. In each class, drugs are listed alphabetically by either brand name or generic name. 600 E Boulevard Ave Dept 325. %PDF-1.7 201 W. Preston Street, Baltimore, MD 21201-2399 (410) 767-6500 or 1-877-463-3464 201 W. Preston Street, Baltimore, MD 21201-2399 (410) 767-6500 or 1-877-463-3464 New York Medicaid Medicaid-Approved Preferred Drug List. December 2019 . About Medicaid, who is eligible, how to apply. Published By: Medical Services Division. New York Medicaid Medicaid-Approved Preferred Drug List. <> Preferred Drug List - Effective 12/01/2020 Information Disclaimer Providers, please visit our website at Bismarck, ND 58505-0250 . Medicaid Preferred Drug List Page Content You may register to receive E-mail notification, when a new Preferred Drug List is posted to the Web site, by completing the form for Preferred Drug List E-Mail Notification Request . In addition, there are medications and/or classes of medications that are not reviewed by the committee. Preferred Drug List (PDL) & Prior Authorization Criteria . Over-the-counter medications and products. Medicaid Formulary (Drug List) 2020.A formulary is a list of covered drugs.The Medicaid formulary is a useful reference to assist practitioners in selecting clinically appropriate and cost-effective drug therapies.Medicaid Formulary Updates. Revised 12/22/2020: Preferred Drug List Quick Reference (Effective 1/1/2021) Diabetic Supply List Quick Reference (Effective 10/1/2020) Over-the-Counter Drugs. Find out more. Highlights indicated change from previous posting. PDL_January_1_2020.pdf. Effective: January 1, 2020 The. NC Medicaid would like to share information about recent FDA guidance regarding REMS requirements during the COVID-19 public health emergency. Please see your 2020 Formulary document for details. 2020 Over-the-Counter (OTC) Catalog - WellCare Live www.wellcare.com • See your list of wellness services • Find doctors and urgent care centers Save Time With Convenient Self-Service Tools Self-service tools are available on your schedule, 24/7, any day of the year. Alphabetical by drug name - Posted 12/02/20. 4344, or Magellan Medicaid Administration (MMA) at (866) 664-4506. Molina Healthcare of Washington Medicaid Preferred Drug List (Formulary) (11/01/2020) INTRODUCTION. Drug Plan. This is a list of drugs covered by your plan. DO: Dose Optimization Program . Preferred Drug List (PDL) & Prior Authorization Criteria . The 2020 Medicaid Pharmacy Newsletters can be viewed here. The quarterly P&T Committee meeting was held on September 18, 2020. NC DHHS Division of Health Benefits | NC Medicaid and NC Health Choice Preferred Drug List Review Panel Meeting | July 15, 2020 15 NSAIDs Slide 1 of 2 Preferred Non-Preferred ibuprofen suspension / tablet (generic for Motrin®) Arthrotec® Tablet indomethacin capsule (generic for … AL: Age Limit Restrictions . Brand name drug: Uppercase in bold type . Medicaid Fee for Service Outpatient Pharmacy Program represents the preferred and non-preferred drug products as well as drugs requiring prior approval, quantity level limits, and therapy limits. Providers. �Ĭ�������'��ᚎ�nZ��Id$�)I����t粁4�;�������.���� BRAND PREFFERED (DX CODE REQ)ADAPALENE DIHYDROERGOTAMINE 4 MG/ML SPRY (NASAL) DILTAIZEM 24HR ER CAPSULE (not TABLET) (ORAL) DILTIAZEM 12HR ER CAPSULE (ORAL) DILTIAZEM TABLET (ORAL) Updated October 1, 2020 4 of 16. Legend . North Carolina Division of Health Benefits North Carolina Medicaid and Health Choice Preferred Drug List (PDL) Effective: December 1, 2020 Trial and failure of two Preferred drugs are required unless only one Preferred option is listed or is otherwise indicated. Facilitator, Blake Cook, NC Medicaid Outpatient Pharmacy Interim Pharmacy Director began the meeting by welcoming attendees to the … NC Medicaid and Health Choice Clinical Coverage Policy for Outpatient Pharmacy Services; 2020 NC Medicaid Pharmacy Newsletters; 2019 NC Medicaid Pharmacy Newsletters; NC Medicaid Preferred Drug List; NC Medicaid Provider Bulletins This document can assist medical providers in selecting �6")T�k3w�W.�˭vF��1�Y��~%��� '�p�.J�7Ge�i�Ho���� JUJ2IgM��P�&��0�����+�[�B� �`W�����S����CP�[���p�jr�{,�K|����@áT�v��P��R'. Please see … Drug List by the + symbol. Pharmacy Lock-in Program. Through our combined efforts we ensure that our members continue to trust us to help them in their quest to lead longer and more satisfying lives. Effective December 1, 2020. Details: Florida Medicaid Preferred Drug List (effective 10-01-2020) The Florida Medicaid Preferred Drug List (PDL) is subject to revision following consideration and recommendations by the Pharmaceutical and Therapeutics (P&T) Committee and the Agency for Health Care Administration. (PDL) effective March 1, 2020 PDF • 684.34 KB Download PDL_February_1_2020.pdf NC Medicaid and Health Choice Preferred Drug List SPECIAL BULLETIN: UPDATE on NC Medicaid Temporary Flexibilities due to Hurricane Dorian Apple Health PDL 10/23/2020 - 10/29/2020; Apple Health PDL 10/16/2020 - 10/22/2020; Apple Health PDL 10/9/2020 - 10/15/2020; Apple Health PDL 10/1/2020 - 10/8/2020; View all Apple Health PDLs. Montana Medicaid Preferred Drug List (PDL) Revised October 28, 2020 *Indicates a generic is available without prior authorization This list may not include all available generic formulations listed specifically by name Note: Brand Named Drugs are capitalized, generic drugs start with lower case letters. Find out more. Covered (BadgerCare Plus and Medicaid) (Effective 1/1/2018) 2 Preferred Drug List What is the Preferred Drug List? Data valid as of 12/26/2020. 2 Preferred Drug List What is the Preferred Drug List? THIS FORMULARY WAS UPDATED ON 11/05/2020. Please read the first page for important additional information. If you would like to report a concern or problem about the PDL program, you … <> Version 2020.1 . North Carolina State Health Plan Preferred Drug List - Traditional Pharmacy Benefit . WELCOME AND INTRODUCTIONS. Preferred Brands with Non-preferred Generics on the Preferred Drug List (PDL) Providers are encouraged to review this important information. 2020 LIST OF COVERED DRUGS (FORMULARY) Health Details: v UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program.Enrollment in the plan depends on the plan’s contract renewal with Medicare. Preferred Drug List (PDL). Oregon Health Plan Preferred Drug List, a list of the most cost-effective drugs to prescribe for fee-for-service members. Louisiana Medicaid Preferred Drug List (PDL)/Non-Preferred Drug List (NPDL) • The PDL is a list of over 100 therapeutic classes reviewed by the Pharmaceutical & Therapeutics (P&T) committee. OFLOXACIN … %���� Preferred Drug List – Idaho Health and Welfare. Generic drug: Lowercase in plain type . <>/Font<>/XObject<>/Pattern<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 720 540] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Alphabetical by drug name - Posted 11/02/20. Note: Highlights indicated change from previous posting. THIS FORMULARY WAS UPDATED ON 11/05/2020. Drug List (PDL) / Common Core Formulary QuickList Effective January 1, 2020 General Information: • Virginia Medicaid’s Preferred Drug List (PDL) only includes select drug classes • PDL preferred drugs do not require Service Authorizations (SA) unless subject to additional clinical criteria (e.g., long acting opioids, hepatitis C therapies, Idaho Medicaid Preferred Drug List with Prior Authorization Criteria. 2020 Preferred Drug List Humana Medical Plan All Regions PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN. Drug List (PDL) / Common Core Formulary QuickList Effective January 1, 2020 General Information: • Virginia Medicaid’s Preferred Drug List (PDL) only includes select drug classes • PDL preferred drugs do not require Service Authorizations (SA) unless subject to additional clinical criteria (e.g., long acting opioids, hepatitis C therapies, Home | UAC | Reference | Site Map. The WellCare Drug List (Formulary) tool allows you to search prescription drug names to determine 2021 plan coverage for your formulary. Over-the-counter medications and products. Blue Cross NC’s prior review, restricted-access, non-formulary exceptions and If you have additional questions about the PDL program, you may contact Medicaid Client Services at (800) 852-3345, ext. North Carolina Division of Health Benefits North Carolina Medicaid and Health Choice Preferred Drug List (PDL) Effective: February 1, 2020 T. Preferred Non-Preferred. The 2020 Medicaid Pharmacy Newsletters can be viewed on the DHB website. Generic drug: Lowercase in plain type . Details: Florida Medicaid Preferred Drug List (effective 10-01-2020) The Florida Medicaid Preferred Drug List (PDL) is subject to revision following consideration and recommendations by the Pharmaceutical and Therapeutics (P&T) Committee and the Agency for Health Care Administration. PDL Updated January 1, 2020. If you are already taking a drug not on the Preferred Drug List or your drugs gets removed from the Preferred Dru… AmeriHealth Caritas North Carolina covers certain over-the-counter medications and products. x��U�o�0~�����jۉ�D�* �JQ[�i��`h$[�*�ߝ�X���Ѿ\��~|w�������Y��л��w� �B*%b�� ���}9����w�kߓ0�)#E��Ҟ���g߃s� Please note that the South Carolina Medicaid Preferred Drug List is updated quarterly. That pledge demands the highest standards of care and service. The 2020 Medicaid Pharmacy Newsletters can be viewed here. No Copayment for Pregnant NC Medicaid Beneficiaries for Covered Prescription Drugs; Preferred Brands with Non-Preferred Generics on the Preferred Drug List (PDL) (Current as of September 25, 2020) Providers are encouraged to review this important information. The quarterly P&T Committee meeting was held on September 18, 2020. Friday, March 27, 2020 Preferred Drug List (PDL) Update Effective March 25, 2020, due to drug shortages in the marketplace, the NC Medicaid and NC Health Choice PDL Category of “Respiratory: Beta-Adrenergic Handheld, Short Acting” has changed to the following: NC Medicaid and Health Choice Preferred Drug List (PDL) effective Jan. 1, 2020 Connecticut Medicaid Preferred Drug List (PDL) DO: Dose Optimization Program . In each class, drugs are listed alphabetically by either brand name or generic name. Preferred Drug List (PDL). View the NC Medicaid PDL to find a covered medicine. Suprax susp® Trial and failure of 2 Preferred products required prior to Non-Preferred products. SPECIAL BULLETIN COVID-19 #24: NC Medicaid Cost Report Filing Extensions Due to COVID-19 SPECIAL BULLETIN COVID-19 #25: Emergency Update to NC Medicaid and NC Health Choice Preferred Drug List (PDL) and REMS Program Flexibilities stream �1��v���gg�4����JA���M0�' )Lf���(�ah ���d�$*BJ*��I��;����r{�{��D�!>�`P +�AG�btBV��ڌn�� ���lI donepezil 5mg, 10mg tablet/ODT (generic for Aricept®/ ODT) Aricept®Tablet Exelon®Patch donepezil 23mg tablet (generic for Aricept®) memantine tablet/titration pack (generic for Namenda®) galantamine ER capsule / solution / tablet … NC Medicaid Opioid Safety STOP Act Crosswalk (PDF, 319 KB) FAQ on Naloxone Standing Order (PDF, 251 KB) Provider Considerations for Tapering of Opioids (PDF, 221 KB) Preferred Drug List Opioid Analgesics and Combination Therapy Daily MME (PDF, 389 KB) General Provider Pharmacy Cover Letter - STOP Act (PDF, 137 KB) To get drugs not on the Preferred Drug List, your provider will need to get prior authorization from Health First Colorado. <>/Metadata 3184 0 R/ViewerPreferences 3185 0 R>> 919-855-4100 (Main Office) 1-800-662-7030 (DHHS Customer Service) Local County Department of Social Services Archived Web Announcements; Documents. For an up-to-date list of covered drugs or if you have questions, please call Customer Service. Locate contact information for state agencies, employees, hotlines, local offices, and more. UNIVERSAL PREFERRED DRUG LIST (For All Medicaid, MSCAN and CHIP Beneficiaries) Conduent’s SmartPA Pharmacy Application (SmartPA) is a proprietary electronic prior authorization system used for Medicaid fee for service claims. v The Drug List (formulary) may change on January 1 of each year, and from time to time during the plan year. Effective March 25, 2020, due to drug shortages in the marketplace, the NC Medicaid and NC Health Choice PDL Category of “Respiratory: Beta-Adrenergic Handheld, Short Acting” has changed to the following: Please visit the following site for a full PDL listing: https://medicaid.ncdhhs.gov/documents/preferred-drug-list. We are pleased to provide the 2020 Molina Healthcare of Washington Apple Health (Medicaid) Preferred Drug List (Formulary) as a useful reference and informational tool. The … • Preferred Drug List Partners in Quality Care Dear Provider Partner: members – your patients. The PDL was authorized by the NC General Assembly Session Law 2009-451, Sections 10.66(a)-(d). December 2019 . Welcome to the Nebraska Medicaid program Web site. Suprax susp® Trial and failure of 2 Preferred products required prior to Non-Preferred products. is a guide within select therapeutic categories for plan members enrolled in the traditional pharmacy benefit and their health care providers. PREFERRED NON-PREFERRED. Please see … Drug List by the + symbol. Preferred Drug List – Idaho Health and Welfare. AL: Age Limit Restrictions . Stay up to date with us. Rx (PDP) Medicare Prescription. Fee-for-service plan only Preferred drug lists (PDL) The Apple Health (Medicaid) Fee-For-Service Preferred Drug List no longer applies. Bismarck, ND 58505-0250 . Perform the search via the following steps: Search for a Drug … 2020 Preferred Drug List (PDL) - November 2020. Our contact information is on the cover. View the NC Medicaid PDL to find a covered medicine. Published By: Medical Services Division. NON-PREFERRED –. 2 0 obj Open the attached list and use the Adobe Acrobat search tool to locate specific drugs by name or HIC3 therapeutic class. NC Department of Health and Human Services 2001 Mail Service Center Raleigh, NC 27699-2001 919-855-4800 donepezil 5mg, 10mg tablet/ODT (generic for Aricept®/ ODT) Aricept®Tablet Exelon®Patch donepezil 23mg tablet (generic for Aricept®) memantine tablet/titration pack (generic for Namenda®) galantamine ER capsule / solution / tablet … I. No Copayment for Pregnant NC Medicaid Beneficiaries for Covered Prescription Drugs; Preferred Brands with Non-Preferred Generics on the Preferred Drug List (PDL) (Current as of September 25, 2020) Providers are encouraged to review this important information. › Verified 3 days ago Rx (PDP) Medicare Prescription. 2020 Preferred Drug List Humana Medical Plan All Regions PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN. 600 E Boulevard Ave Dept 325. The Preferred Drug List (PDL) is a medication list recommended to the Bureau for Medical Services by the Medicaid Pharmaceutical and Therapeutics (P & T) Committee and approved by the Secretary of the Department of Health and Human Resources, as authorized by West Virginia Code §9-5-15. 2021 WellCare Drug List (Formulary) Search Tool. Effective December 1, 2020. Florida Medicaid Preferred Drug List (effective 10-01-2020) The Florida Medicaid Preferred Drug List (PDL) is subject to revision following consideration and recommendations by the Pharmaceutical and Therapeutics (P&T) Committee and the Agency for Health Care Administration. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) December 2020 Essential 6 Tier Formulary III The FDA is responsible for approving medications for use based on clinical data proving the medication is safe and effective for that specific use. Pharmacy Lock-in Program. The Preferred Drug List below was updated from the September 18, 2020 P&T Committee meeting. Medicaid List of Covered Drugs (Formulary) 2020 ... cover the drugs listed in the list of covered drugs as long as the drug is medically necessary, the prescription is filled at a HealthPartners network pharmacy and other require ments related to the drug are followed. Version 2020.1 . NORTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES 2020 PREFERRED DRUG LIST REVIEW PANEL MEETING WEDNESDAY JULY 15, 2020 1:00PM- 5:00PM VIRTUAL ONLINE MEETING PLATFORM. NC Medicaid Opioid Safety STOP Act Crosswalk (PDF, 319 KB) FAQ on Naloxone Standing Order (PDF, 251 KB) Provider Considerations for Tapering of Opioids (PDF, 221 KB) Preferred Drug List Opioid Analgesics and Combination Therapy Daily MME (PDF, 389 KB) General Provider Pharmacy Cover Letter - STOP Act (PDF, 137 KB) 2020 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. 2020 Preferred Drug List (PDL) - December 2020. The Health First Colorado (Colorado's Medicaid Program) Preferred Drug Listincludes clinically effective medications that you can get without needing prior authorization or approval. 3 0 obj Please see your 2020 Formulary document for details. endobj Louisiana Medicaid Preferred Drug List (PDL)/Non-Preferred Drug List (NPDL) • The PDL is a list of over 100 therapeutic classes reviewed by the Pharmaceutical & Therapeutics (P&T) committee. Preferred Drug List. Silver State Scripts Board Makes Changes to Preferred Drug List (PDL) Effective June 1, 2020 Jan. 2, 2020 Silver State Scripts Board Makes Changes to Preferred Drug List (PDL) Effective January 1, 2020 Not all … Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLC 2020 Medicare Part D Browse a Plan Formulary (Drug List) - Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. To review the most up-to-date information, please use the DHS NDC Search.. Search by Drug Name (minimum first 3 characters, maximum 25 characters) or NDC or Therapeutic Class, and Major Program with Date of Service (in the last year). 2020 LIST OF COVERED DRUGS (FORMULARY) Health Details: v UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program.Enrollment in the plan depends on the plan’s contract renewal with Medicare. Legend . Alphabetical by drug therapeutic class - Posted 12/02/20 Get email alerts on latest news and upcoming events. North Dakota Department of Human Services. Prescribers are encouraged to write prescriptions for “preferred” products. The NC Medicaid Preferred Drug List (PDL) allows NC Medicaid to obtain better prices for covered outpatient drugs through supplemental rebates. Medicaid Fee for Service Outpatient Pharmacy Program represents the preferred and non-preferred drug products as well as drugs requiring prior approval, quantity level limits, and therapy limits. 4 0 obj endobj The drug should be filled at an in-network pharmacy and … Details: The Ohio Department of Medicaid is implementing a Unified Preferred Drug List (UPDL) on January 1st, 2020 that will encompass the entire Medicaid population regardless of enrollment in Managed Care or Fee for Service (FFS). We’re committed to quality. Idaho Medicaid Preferred Drug List with Prior Authorization Criteria. Preferred Drug List (PDL) The Alabama Medicaid Agency preferred drug list is determined by decisions made by the Medicaid Pharmacy and Therapeutics (P&T) Committee which is required by state law to advise and assist the agency in the development of a drug plan. Blue Cross and Blue Shield of North Carolina (Blue Cross NC) December 2020 Essential 6 Tier Formulary III The FDA is responsible for approving medications for use based on clinical data proving the medication is safe and effective for that specific use. NC Medicaid (Division of Health Benefits) is dedicated to providing access to physical and behavioral health care and services to improve the health and well-being of over 2.1 million North Carolinians on behalf of the North Carolina Department of Health and Human Services. Preferred Drug List [1.08MB PDF] Updated 10/14/2020. PREFERRED NON-PREFERRED. AmeriHealth Caritas North Carolina covers certain over-the-counter medications and products. This drug list has changed since last … Virginia Medicaid’s Preferred Drug List (PDL)/Common Core Formulary 7/1/20 3 | P a g e *Methadone Drugs Dolophine® Methadose® oral soln & tab methadone oral soln & tab *Methadone requires the completion of the Clinical SA form (Methadone SA Form) unless prescribed for neonatal abstinence syndrome for an infant under the age of one. Effective: January 1, 2020 endobj Our lock-in program assigns members to a specific pharmacy and prescriber provider. v The Drug List (formulary) may change on January 1 of each year, and from time to time … Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLC PDL Updated January 1, 2020. Most cost-effective drugs to prescribe for fee-for-service members fee-for-service plan only Preferred Drug List Formulary... A covered medicine MMA ) at ( 866 ) 664-4506 ( Medicaid ) fee-for-service Preferred Drug List, your will. 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