Effective January 5, 2015, the Alabama Medicaid Agency will:
- Require prior authorization for payment of atovaquone oral suspension (generic Mepron oral suspension). Brand Mepron oral suspension will be preferred with no PA.
- Use Dispense as Written (DAW) Code of 9 for brand Mepron oral suspension. DAW Code of 9 indicates the following: Substitution Allowed by Prescriber but Plan Requests Brand - Patient's Plan Requested Brand Product to be Dispensed.
- Update the Preferred Drug List (PDL) to reflect the quarterly updates. The updates are listed below:
PDL Additions |
Humalog Mix 50-50 |
Anti-diabetic Agents/Insulins |
Humalog Mix 75-25 |
Anti-diabetic Agents/Insulins |
Mepron |
Anti-infective Agents/Antiprotozoals, Miscellaneous |
Novolog |
Anti-diabetic Agents/Insulins |
Novolog Mix 70-30 |
Anti-diabetic Agents/Insulins |
PDL Deletions |
Gris-Peg |
Anti-infective Agents/Antifungals, Miscellaneous |
Infergen |
Anti-infective Agents/Interferons |
For more information, visit the Alabama Medicaid announcement by clicking here or download the PDF file listed below.