23
Nov
2015
Effective December 28, 2015, Amerigroup will be adding drugs to their
Prior Authorization (PA) program for Medicaid. The goal of this program is to ensure the medication is being used for FDA-approved indications for therapy. PA criteria for the drugs listed in the table on page two of this communication were reviewed and approved by the Kansas Drug Utilization Review Board.
Please note that claims for the additional medications included in the PA program will reject with NCPDP reject code 75 (Prior Authorization Required). Please contact the prescriber for approval.
The prescriber/physician must request prior authorization by calling the Express Scripts pharmacy department at 1.855.201.7170 and following the prompts.
4
Sep
Beginning October 1, 2015, Amerigroup will no longer be a provider of Healthy Kids benefits in certain Florida Statewide Medicaid Managed Care Regions, but will expand to other regions not currently in its service area.
18
Aug
Beginning September 1, 2015, Express Scripts will be the pharmacy benefits manager (PBM) for Amerigroup Georgia Families 360° members.
27
Jul
The Agency for Healthcare Administration (AHCA) released a memo earlier this year stating that effective April 1, 2015, spacers will only be reimbursed through the Durable Medical Equipment (DME) benefit for Florida Medicaid Statewide Medicaid Managed Care (SMMC) members.
1
Jun
Inside this issue:
Amerigroup TX Medicaid & CHIP…...2-4