6/8/2015

Effective July 1, 2015, the Alabama Medicaid Agency will:

1. Require prior authorization (PA) for payment of non-preferred brand Oral Anticoagulants.
2. Require prior authorization for payment of clonidine HCL ER (generic Kapvay). Brand Kapvay will be preferred with no PA.

·         Use Dispense as Written (DAW) Code of 9 for brand Kapvay. DAW Code of 9 indicates the following: Substitution Allowed by Prescriber but Plan Requests Brand - Patient's Plan Requested Brand Product to be dispensed.

3. Require prior authorization for payment of dexmethylphenidate HCL ER (generic Focalin XR).  Brand Focalin XR will continue to be preferred with no PA.

·         Use Dispense as Written (DAW) Code of 9 for brand Focalin XR.  DAW Code of 9 indicates the following: Substitution Allowed by Prescriber by Plan Requests Brand – Patient’s Plan Requested Brand Products to be dispensed.

4. Remove prior authorization from zafirlukast (generic Accolate).  Brand Accolate will now require PA.
5. Remove prior authorization from levalbuterol inhalation solution (generic Xopenex Inhalation Solution).  Brand Xopenex Inhalation Solution will now require PA.
6. Update the Preferred Drug List (PDL) to reflect the quarterly updates. The updates are listed below: