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TO:  Pharmacies, Physicians, Physician Assistants, Nurse Practitioners, Oral Surgeons, Optometrists, Dentists, FQHCs, RHCs, Mental Health Service Providers and Nursing Homes

Effective April 1, 2016, the Alabama Medicaid Agency will:

1. Require prior authorization (PA) for payment of esomeprazole magnesium (generic Nexium). Brand Nexium will be preferred without PA.
   Use Dispense as Written (DAW) Code of 9 for brand Nexium. DAW Code of 9 indicates the following: Substitution Allowed by Prescriber but Plan Requests Brand. This value is used when the prescriber has indicated, in a manner specified by prevailing law, that generic substitution is permitted, but the Plan requests the brand product to be dispensed. 
    
2. Update the Preferred Drug List (PDL) to reflect the quarterly updates.
   The updates are listed below:
   
   

   PDL Additions
   Nexium	Proton-Pump Inhibitors
   Relpax	Selective Serotonin Agonists

   
   
3. Include Vitamin D 50,000 unit capsules in the mandatory three-month maintenance supply program. 
   Prescriptions for three-month maintenance supply medications will not count toward the monthly prescription limit.  A maintenance supply prescription will be required after 60 day’s stable therapy.  Please see the website for a complete listing of maintenance supply medications.