News

Preferred Drug List Update

3/12/2012

Attention:  Pharmacies, Physicians, Physician Assistants, Nurse

Practitioners, Oral Surgeons, Optometrists, Dentists, FQHCs,

RHCs, Mental Health Service Providers and Nursing Homes

 

 

 

Effective April 2, 2012, the Alabama Medicaid Agency will update the Preferred Drug List (PDL) to reflect the recent Pharmacy and Therapeutics (P&T) Committee’s recommendations as well as quarterly updates. The updates are listed below: 

 

PDL Additions

PegIntron

Anti-infective Agents/Interferons

PDL Deletions*

Avalide

Cardiovascular Health/Angiotensin II Receptor Antagonists

Avapro

Cardiovascular Health/Angiotensin II Receptor Antagonists

Benicar

Cardiovascular Health/Angiotensin II Receptor Antagonists

Benicar HCT

Cardiovascular Health/Angiotensin II Receptor Antagonists

Cleocin

Anti-infective Agents/Miscellaneous Antibacterials

Focalin

Behavioral Health/Cerebral Stimulants/Agents for ADD/ADHD-Short and Intermediate Acting

Pegasys

Anti-infective Agents/Interferons

* Denotes that these brands will no longer be preferred but are still covered by Alabama Medicaid and will require Prior Authorization (PA). Available covered generic equivalents (unless otherwise specified) will remain preferred.

For additional PDL and coverage information, visit our drug look-up site at https://www.medicaid.alabamaservices.org/ALPortal/NDC%20Look%20Up/tabId/39/Default.aspx.

The PA request form and criteria booklet, as well as a link for a PA request form that can be completed and submitted electronically online, can be found on the Agency’s website at www.medicaid.alabama.gov and should be utilized by the prescribing physician or the dispensing pharmacy when requesting a PA. Providers requesting PAs by mail or fax should send requests to:

Health Information Designs (HID)

Medicaid Pharmacy Administrative Services

P. O. Box 3210 Auburn, AL 36832-3210

Fax: 1-800-748-0116  /  Phone: 1-800-748-0130

 

Incomplete PA requests or those failing to meet Medicaid criteria will be denied. If the prescribing physician believes medical justification should be considered, the physician must document this on the form or submit a written letter of medical justification along with the prior authorization form to HID. Additional information may be requested. Staff physicians will review this information.

 

Policy questions concerning this provider notice should be directed to the Pharmacy Program at (334) 242-5050. Questions regarding prior authorization procedures should be directed to the HID help desk at 1-800-748-0130.