| Year | Code Citation(s) | Subject | Date Issued | Bulletin
Number |
|---|
| Ch. 1121 | Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Growth Hormones Updated Handbook Pages | 06/29/09 | 01-09-19
02-09-16
03-09-16
08-09-20
09-09-20
11-09-16
14-09-16
24-09-19
27-09-16
30-09-16
31-09-21
32-09-16 |
| Ch. 1121 | Automated Prior Authorization of Pharmacy Services—Bronchodilators, Anticholinergic Updated Handbook Pages | 06/29/09 | 01-09-21
02-09-18
03-09-18
08-09-22
09-09-22
11-09-18
14-09-18
24-09-21
27-09-18
30-09-18
31-09-23
32-09-18 |
| Ch. 1121 | Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Acne Agents, Oral Updated Handbook Pages | 06/29/09 | 01-09-10
08-09-11
14-09-07
30-09-07
02-09-07
09-09-11
24-09-10
31-09-12
03-09-07
11-09-07
27-09-08
32-09-07 |
| Ch. 1121 | Automated Prior Authorization of Pharmacy Services—
Lipotropics, Statins Updated Handbook Pages | 06/29/09 | 01-09-15
02-09-12
03-09-12
08-09-16
09-09-16
11-09-12
14-09-12
24-09-15
27-09-12
30-09-12
31-09-17
32-09-12 |
| Ch. 1150 | 2008 HCPCS Updates and Other Procedure Code and Procedure Code/Modifier Combination Changes | 07/06/09 | 99-09-06 |
| Ch. 1121 | Prior Authorization of Benzodiazepines—Pharmacy Services | 07/27/09 | 01-09-31
02-09-28
03-09-28
08-09-32
09-09-32
11-09-28
14-09-28
24-09-31
27-09-29
30-09-28
31-09-33
32-09-28 |
| Ch. 1121 | Prior Authorization of Buprenorphine Agents (Suboxone and Subutex)—Pharmacy Services | 07/27/09 | 01-09-30
02-09-27
03-09-27
08-09-31
09-09-31
11-09-27
14-09-27
24-09-30
27-09-28
30-09-27
31-09-32
32-09-27 |
| Ch. 1121 | Prior Authorization of Topical Acne Agents—Pharmacy Services | 07/27/09 | 01-09-28
02-09-25
03-09-25
08-09-29
09-09-29
11-09-25
14-09-25
24-09-28
27-09-26
30-09-29
31-09-30
32-09-25 |
| Ch. 1121 | State Maximum Allowable Cost (MAC) List (Including the Federal Upper Limit)—Pharmacy Services | 07/27/09 | 01-09-32
02-09-29
03-09-29
08-09-33
09-09-33
11-09-29
14-09-29
24-09-32
27-09-30
30-09-29
31-09-34
32-09-29 |
| Ch. 1121 | Prior Authorization of Cough and Cold Medications for Children Under Six (6) years of Age—Pharmacy Services | 07/27/09 | 01-09-27
02-09-24
03-09-24
08-09-28
09-09-28
11-09-24
14-09-24
24-09-27
27-09-25
30-09-04
31-09-29
32-09-24 |
| — | Special Pharmaceutical Benefits Program (SPBP)—Addition of CD4 Tests to the List of Outpatient Laboratory Services for SP1 Card Holders | 08/03/09 | 01-09-33
08-09-34
09-09-35
21-09-03
24-09-33
28-09-03
31-09-36 |
| Ch. 1105 1150 | Revised Medical Assessment Form
(PA 635) | 08/10/09 | 31-09-38
19-09-01
09-09-34 |
| Ch. 1121 | Prior Authorization of Skeletal Muscle Relaxants—Pharmacy Services | 08/10/09 | 01-09-35
09-09-37
27-09-32
02-09-31
11-09-31
30-09-31
03-09-31
14-09-31
31-09-38
08-09-36
24-09-35
32-09-31 |
| Ch. 1121 | Prior Authorization of Narcotic Analgesics—Pharmacy Services | 08/10/09 | 01-09-34
09-09-36
27-09-31
02-09-30
11-09-30
30-09-30
03-09-30
14-09-30
31-09-37
08-09-35
24-09-34
32-09-30 |
| Ch. 1101
Ch. 1150 | Changes to Procedure Codes for the
Administration Fees for Kinrix® (DTaP-IPV) and Rotarix® (Rotavirus Vaccines) | 08/13/09 | 01-09-38
08-09-39
09-09-40
31-09-41
33-09-03 |
| Ch. 1101
1150
1141
1221 | Select Plan for Women Program
Formulary | 09/01/09 | 01-09-39
08-09-40
09-09-41
24-09-38
28-09-04
31-09-42
33-09-04 |
| Ch. 1121 | SUBJECT Prior Authorization of Atypical Antipsychotics—Pharmacy Services | 09/01/09 | 01-09-36
09-09-38
27-09-33
02-09-32
11-09-32
30-09-32
03-09-32
14-09-32
31-09-39
08-09-37
24-09-36
32-09-32 |
| Ch. 1101 1150
1141
1221 | Select Plan for Women Program—Addition of Covered Services | 09/08/09 | 01-09-40
08-09-41
09-09-42
24-09-39
28-09-05
31-09-43
33-09-05 |
| Ch. 1150
1241
| Structured Screening for Developmental
Delays and Autism Spectrum Disorders
| 09/08/09
| 99-09-07
|
| | Ch. 1121 | Prior Authorization of Neulasta—Pharmacy Services | 09/17/09 | 01-09-29 02-09-26
03-09-26
08-09-30
09-09-30
11-09-26
14-09-26
24-09-29
27-09-27
30-09-26
31-09-31
32-09-26 |
| Ch. 1121 | Prior Authorization of Conventional (Typical) Antipsychotics—
Pharmacy Services | 09/21/09 | 01-09-37
09-09-39
27-09-34
02-09-33
11-09-33
30-09-33
03-09-33
14-09-33
31-09-40
08-09-38
24-09-37
32-09-33 |
| Ch. 1121 | Available Resources: 2009 Novel Influenza Virus A (H1N1) | 09/24/09 | 01-09-41
08-09-42
09-09-43
31-09-44
33-09-06 |
| Ch. 1141 | Revisions to the Medical Assistance Program Fee Schedule Rates for Select Services | 10/05/09 | 99-09-09 |
| Ch. 1150 | Billing for the Administration of the Influenza A (H1N1) 2009 Monovalent Vaccine | 10/09/09 | 99-09-10 |
| Ch. 1101 1141
1142
1143
1144
1145. 1147
1149 | Revision of the PROMISe® Individual
Practitioner Enrollment Application and Implementation of Credentialing for Certain
Providers Types | 10/16/09 | 99-09-08 |
| Ch. 1121 | Prior Authorization of Proton Pump Inhibitors (PPIs)—Pharmacy Services | 10/20/09 | 01-09-42
08-09-43
14-09-34
30-09-34
02-09-34
09-09-44
24-09-40
31-09-45
03-09-34
11-09-34
27-09-35
32-09-34 |
| Ch. 1121 | Fall 2009 Preferred Drug List (PDL) and Quantity Limits Update—Pharmacy Services | 11/02/09 | 01-09-43
09-09-45
27-09-36
02-09-35
11-09-35
30-09-35
03-09-35
14-09-35
31-09-46
08-09-44
24-09-41
32-09-35 |
| Ch. 1141 1145 | Recipient Access to Chiropractic
Services | 11/30/09 | 99-09-11 |
| Ch. 1121 | Steroids, Topical Low Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update | 11/02/09 | 01-09-51
09-09-53
27-09-44
02-09-43
11-09-43
30-09-43
03-09-43
14-09-43
31-09-54
08-09-52
24-09-49
32-09-43 |
| Ch. 1121 | Ophthalmic Antibiotics Updated Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update | 11/02/09 | 01-09-58
09-09-59
27-09-50
02-09-49
11-09-49
30-09-49
03-09-49
14-09-49
31-09-60
08-09-58
24-09-55
32-09-49 |
| Ch. 1121 | Steroids, Topical High Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update | 11/02/09 | 01-09-54
09-09-55
27-09-46
02-09-45
11-09-45
30-09-45
03-09-45
14-09-45
31-09-56
08-09-54
24-09-51
32-09-45 |
| Ch. 1121 | Platelet Aggregation Inhibitors Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update | 11/02/09 | 01-09-47
09-09-49
27-09-40
02-09-39
11-09-39
30-09-39
03-09-39
14-09-39
31-09-50
08-09-48
24-09-45
32-09-39 |
| Ch. 1121 | Pharmacy Services Fall 2009 Preferred Drug List (PDL) Pharmacy Update—Bronchodilators, Beta Agonists Updated Handbook Pages | 11/02/09 | 01-09-48
09-09-50
27-09-41
02-09-40
11-09-40
30-09-40
03-09-40
14-09-40
31-09-51
08-09-49
24-09-46
32-09-40 |
| Ch. 1121 | Antivirals, Topical Updated Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update | 11/02/09 | 01-09-57
09-09-58
27-09-49
02-09-48
11-09-48
30-09-48
03-09-48
14-09-48
31-09-59
08-09-57
24-09-54
32-09-48 |
| Ch. 1121 | Ophthalmic Anti-Inflammatories New Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update | 11/02/09 | 01-09-49
09-09-51
27-09-42
02-09-41
11-09-41
30-09-41
03-09-41
14-09-41
31-09-52
08-09-50
24-09-47
32-09-41 |
| Ch. 1121 | Pancreatic Enzymes Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update | 11/02/09 | 01-09-50
09-09-52
27-09-43
02-09-42
11-09-42
30-09-42
03-09-42
14-09-42
31-09-53
08-09-51
24-09-48
32-09-42 |
| Ch. 1121 | Steroids, Topical Very High Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update | 11/02/09 | 01-09-55
09-09-56
27-09-47
02-09-46
11-09-46
30-09-46
03-09-46
14-09-46
31-09-57
08-09-55
24-09-52
32-09-46 |
| | | | |
| Ch. 1121 | Fall 2009 Preferred Drug List (PDL) and Quantity Limits Update—Pharmacy Services | 11/02/09 | 01-09-44
09-09-46
27-09-37
02-09-36
11-09-36
30-09-36
03-09-36
14-09-36
31-09-47
08-09-45
24-09-42
32-09-36 |
| Ch. 1121 | Steroids, Topical Medium Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update | 11/02/09 | 01-09-52
09-09-54
27-09-45
02-09-44
11-09-44
30-09-44
03-09-44
14-09-44
31-09-55
08-09-53
24-09-50
32-09-44 |
| Ch. 1121 | Antidepressants, Other Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update | 11/02/09 | 01-09-45
09-09-47
27-09-38
02-09-47
11-09-37
30-09-37
03-09-47
14-09-37
31-09-48
08-09-46
24-09-43
32-09-37 |
| Ch. 1121 | Antifungals, Oral Updated Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update | 11/02/09 | 01-09-46
09-09-48
27-09-39
02-09-38
11-09-38
30-09-38
03-09-38
14-09-38
31-09-49
08-09-47
24-09-44
32-09-38 |
| Ch. 1121 | Bone Resorption Suppression and Related Agents Updated Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update | 11/02/09 | 01-09-56
09-09-57
27-09-48
02-09-47
11-09-47
30-09-47
03-09-47
14-09-47
31-09-58
08-09-56
24-09-53
32-09-47 |
| Ch. 1143 | Correction to Medical Assistance Bulletin 14-06-04 for Podiatrists | 11/30/09 | 14-09-50 |
| Ch. 1121 | Prior Authorization and Quantity Limits of Botulinum Toxins Pharmacy Services | 12/11/09 | 01-09-61
09-09-62
27-09-53
02-09-52
11-09-52
30-09-52
03-09-52
14-09-52
31-09-63
08-09-61
24-09-58
32-09-52 |
| Ch. 1121 | Preferred Drug List (PDL) New Drugs to Market Handbook Pages Pharmacy Services | 12/11/09 | 01-09-60
09-09-61
27-09-52
02-09-51
11-09-51
30-09-51
03-09-51
14-09-51
31-09-62
08-09-60
24-09-57
32-09-51 |
| — | Prone Restraints in Children's Facilities | 12/19/09 | 3800-09-02 |
| — | Strategies and Practices to Eliminate the Use of Unnecessary Restraints | 12/19/09 | 3800-09-01 |
| Ch. 1101 1150
1241 | Hiberix®, Haemophilus Influenzae
Type b (Hib) Vaccine | 12/31/09 | 01-09-62
08-09-61
09-09-62
31-09-64
33-09-07 |
| 2010 | — | Special Pharmaceutical Benefits Program (SPBP)-Implementation of the Revised HIV/AIDS Formulary for SP1 Cardholders | 01/25/10 | 08-10-02
09-10-02
24-10-02
31-10-02 |
| Ch. 1121 | List of Drugs with Established Quantity Limits/Daily Dose Limits—Pharmacy Services | 01/29/10 | 01-10-01
09-10-01
27-10-01
02-10-01
11-10-01
30-10-01
03-10-01
14-10-01
31-10-01
08-10-01
24-10-01
32-10-01 |
| Ch. 1121 | Prior Authorization of Erythropoiesis Stimulating Proteins—Pharmacy Services | 01/29/10 | 01-10-03
09-10-04
27-10-02
02-10-01
11-10-01
30-10-01
03-10-01
14-10-01
31-10-01
08-10-01
24-10-01
32-10-01 |
| Ch. 1121 | Prior Authorization of Incretin Mimetic/Enhancer Hypoglycemics—Pharmacy Services | 02/05/10 | 01-10-05
09-10-06
27-10-04
02-10-04
11-10-04
30-10-04
03-10-04
14-10-04
31-10-07
08-10-06
24-10-05
32-10-04 |
| Ch. 1150 | Health Care Benefit Package 12 Updated Employability Assessment Procedure Code List | 02/05/10 | 01-10-02
08-10-03
09-10-03
18-10-01
28-10-01
29-10-01
31-10-03 |
| Ch. 1147 | Medical Assistance Program Outpatient Fee Schedule Procedure Code Changes for Vision Services | 02/15/10 | 18-10-02
31-10-05 |
| Ch. 1150 | Medical Assistance Program Fee Schedule Revisions | 02/19/10 | 99-10-01 |
| Ch. 1101
1150
1241 | 2010 Recommended Childhood and
Adolescent Immunization Schedules | 03/15/10 | 01-10-06
08-10-07
09-10-07
31-10-09
33-10-01 |
| Ch. 1141
1144
| Application of Topical Fluoride
Varnish by Physicians and CRNPs
| 03/15/10
| 09-10-08
31-10-08
|
| | Ch. 1121 | Prior Authorization of Neulasta—Pharmacy Services | 04/01/10 | 01-10-07
09-10-09
27-10-05
02-10-05
11-10-05
30-10-05
03-10-05
14-10-05
31-10-10
08-10-08
24-10-06
32-10-05 |
| Ch. 1121 | Oral Buprenorphine Agents Updated Handbook Pages—Pharmacy Services | 04/03/10 | 01-10-04
09-10-05
27-10-03
02-10-03
11-10-03
30-10-03
03-10-03
14-10-03
31-10-06
08-10-05
24-10-04
32-10-03 |
| — | Implementation of New Physical Health Managed Care Organizations in the HealthChoices Southeast and Lehigh/Capital Zones | 04/23/10 | 99-10-02 |
| Ch. 1121 | Analgesics, Narcotic Long Acting Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update | 05/01/10 | 01-10-15
09-10-17
27-10-12
02-10-12
11-10-12
30-10-12
03-10-13
14-10-12
31-10-18
08-10-16
24-10-13
32-10-12 |
| Ch. 1121 | Fibromyalgia Agents Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update | 05/03/10 | 01-10-10
09-10-12
27-10-08
02-10-08
11-10-08
30-10-08
03-10-08
14-10-08
31-10-13
08-10-11
24-10-09
32-10-08 |
| Ch. 1121 | Spring 2010 Preferred Drug List (PDL) Quantity Limits Update—Pharmacy Services | 05/03/10 | 01-10-08
09-10-10
27-10-06
02-10-06
11-10-06
30-10-06
03-10-06
14-10-06
31-10-11
08-10-09
24-10-07
32-10-06 |
| Ch. 1121 | Oral Immunosuppressive Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update | 05/03/10 | 01-10-12
09-10-14
27-10-10
02-10-10
11-10-10
30-10-10
03-10-10
14-10-10
31-10-15
08-10-13
24-10-11
32-10-10 |
| — | Limitation on Allowable Other Medical Expenses Related to Nursing Facility Services | 05/03/10 | 03-10-02 |
| Ch. 1121 | Multiple Sclerosis Agents Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update | 05/03/10 | 01-10-13
09-10-15
27-10-11
02-10-11
11-10-11
30-10-11
03-10-11
14-10-11
31-10-16
08-10-14
24-10-12
32-10-11 |
| Ch. 1121 | Hepatitis C Agents Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update | 05/03/10 | 01-10-11
09-10-13
27-10-09
02-10-09
11-10-09
30-10-09
03-10-09
14-10-09
31-10-14
08-10-12
24-10-10
32-10-09 |
| Ch. 1121 | Antidepressants, Other Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update | 05/03/10 | 01-10-09
09-10-11
27-10-07
02-10-07
11-10-07
30-10-07
03-10-07
14-10-07
31-10-12
08-10-10
24-10-08
32-10-07 |
| Ch. 1121 | Oral Anticonvulsants Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update | 05/21/10 | 01-10-18
09-10-20
27-10-15
02-10-15
11-10-15
30-10-15
03-10-16
14-10-15
31-10-21
08-10-19
24-10-16
32-10-15 |
| Ch. 1121 | Angiotensin Modulator Combinations Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update | 05/21/10 | 01-10-17
09-10-19
27-10-14
02-10-14
11-10-14
30-10-14
03-10-15
14-10-14
31-10-20
08-10-18
24-10-15
32-10-14 |
| Ch. 1121 | Pulmonary Arterial hypertension Agents, Oral and Inhaled Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update | 05/21/10 | 01-10-16
09-10-18
27-10-13
02-10-13
11-10-13
30-10-13
03-10-14
14-10-13
31-10-19
08-10-17
24-10-14
32-10-13 |
| Ch. 1121 | Analgesics, Narcotic Short Acting Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update | 05/21/10 | 01-10-19
09-10-21
27-10-16
02-10-16
11-10-16
30-10-16
03-10-17
14-10-16
31-10-22
08-10-20
24-10-17
32-10-16 |
| Ch. 1101
1150 | Announcing the Federally Mandated
Change to Electronic Healthcare Transactions for Healthcare and Pharmacy Transactions | 06/08/10 | 99-10-07 |
| Ch. 1101
1150
1241 | Revisions to the Early and Periodic
Screening, Diagnosis and Treatment
(EPSDT) Program Periodicity Schedule | 06/14/10 | 99-10-06 |
| Ch. 1150 | 2009 HCPCS Updates and Other Procedure Code and Procedure Code/Modifier Combination Changes | 06/14/10 | 99-10-05 |
| Ch. 1150 | Health Care Benefit Package 12 Updated Employability Assessment Procedure Code List | 07/09/10 | 01-10-20
08-10-21
09-10-22
18-10-03
28-10-02
29-10-02
31-10-23 |
| Ch. 41 | Change of Protocol for Certain Provider Appeals | 07/09/10 | 99-10-08 |
| Ch. 1101
1102
1121
1123
1149
1151
1163
1181
1187
1230
1243 | Policy Clarification Regarding Written Prescriptions—
Statement of Policy | 07/17/10 | 99-10-03
1101-10-01
1102-10-01
1121-10-01
1123-10-01
1149-10-01
1151-10-01
1163-10-01
1181-10-01
1187-10-01
1230-10-01
1243-10-01 |
| Ch. 1121 | Prior Authorization of Spiriva (Bronchodilators, Anticholinergic)—Pharmacy Services | 07/29/10 | 01-10-21
09-10-23
27-10-17
02-10-17
11-10-17
30-10-17
03-10-18
14-10-17
31-10-25
08-10-22
24-10-18
32-10-17 |
| Ch. 1101 | Select Plan for Women—Update to Covered Services | 07/30/10 | 01-10-22
08-10-24
09-10-21
24-10-19
28-10-03
31-10-26
33-10-03 |
| Ch. 1225 | Changes to the Provision of Hemoglobin Laboratory Services by Family Planning Clinics | 07/30/10 | 08-10-23 |
| Ch. 1121 | Electronic Prescribing for Providers That Have ePrescribing Software | 08/04/10 | 03-10-19
09-10-25
14-10-18
18-10-04
24-10-20
27-10-18
31-10-24
33-10-04 |
| Ch. 1121 | Prior Authorization of Analgesics, Narcotic Long Acting—Pharmacy Services | 08/27/10 | 01-10-26
09-10-28
27-10-21
02-10-20
11-10-20
30-10-20
03-10-22
14-10-21
31-10-29
08-10-27
24-10-23
32-10-20 |
| Ch. 1121 | Prior Authorization of Analgesics, Narcotic Short Acting—Pharmacy Services | 08/27/10 | 01-10-25
09-10-27
27-10-20
02-10-19
11-10-19
30-10-19
03-10-21
14-10-20
31-10-28
08-10-26
24-10-22
32-10-19 |
| Ch. 1121 | Updated List of Drugs with Established Quantity Limits/Daily Dose Limits—Pharmacy Services | 08/27/10 | 01-10-23
09-10-26
27-10-19
02-10-18
11-10-18
30-10-18
03-10-20
14-10-19
31-10-27
08-10-25
24-10-21
32-10-18 |
| Ch. 1101
1150
1241 | Updates to the Medical Assistance Program Fee Schedule for the Administration of the Vaccines Prevnar 13®, Cervarix®, Twinrix®, Recombivax HB®, and Menveo® | 08/30/10 | 01-10-27
08-10-28
09-10-29
31-10-30
33-10-05 |
| | | | |
| Ch. 1150 | Revisions to the Medical Assistance Program Fee Schedule Rates for Select Services | 08/30/10 | 99-10-09 |
| Ch. 1121
| Retrospective Drug Use Review—Pharmacy Services
| 09/01/10
| 99-10-10
|
| | Ch. 1121 | Specialty Pharmacy Drug Program—Updated List of Covered Drugs—Pharmacy Services | 09/27/10 | 99-10-11 |
| Ch. 1145 | Recipient Access to Chiropractic Services | 10/08/10 | 99-10-12 |
| Ch. 1121 | Antipsychotics Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/05/10 | 01-10-33
09-10-35
27-10-25
02-10-24
11-10-24
30-10-24
03-10-26
14-10-25
31-10-36
08-10-34
24-10-27
32-10-24 |
| Ch. 1121 | Analgesics/Anesthetics, Topical Agents Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/05/10 | 01-10-29
09-10-31
27-10-21
02-10-20
11-10-20
30-10-20
03-10-22
14-10-21
31-10-32
08-10-30
24-10-23
32-10-20 |
| Ch. 1121 | Intranasal Rhinitis Agents Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/05/10 | 01-10-41
09-10-43
27-10-33
02-10-32
11-10-32
30-10-32
03-10-34
14-10-33
31-10-44
08-10-42
24-10-35
32-10-32 |
| Ch. 1121 | Oral Fluoroquinolones Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/05/10 | 01-10-39
09-10-41
27-10-31
02-10-30
11-10-30
30-10-30
03-10-32
14-10-31
31-10-42
08-10-40
24-10-33
32-10-30 |
| Ch. 1121 | Fall 2010 Preferred Drug List (PDL) and Quantity Limits Update—Pharmacy Services | 11/05/10 | 01-10-28
09-10-30
27-10-20
02-10-19
11-10-19
30-10-19
03-10-21
14-10-20
31-10-31
08-10-29
24-10-22
32-10-19 |
| Ch. 1121 | Inhaled Glucocorticoids Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/05/10 | 01-10-40
09-10-42
27-10-32
02-10-31
11-10-31
30-10-31
03-10-33
14-10-32
31-10-43
08-10-41
24-10-34
32-10-31 |
| Ch. 1121 | Antihyperuricemics Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/05/10 | 01-10-31
09-10-33
27-10-23
02-10-22
11-10-22
30-10-22
03-10-24
14-10-23
31-10-34
08-10-32
24-10-25
32-10-22 |
| Ch. 1121 | Bronchodilators, Beta Agonists Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/05/10 | 01-10-37
09-10-39
27-10-29
02-10-28
11-10-28
30-10-28
03-10-30
14-10-29
31-10-40
08-10-38
24-10-31
32-10-28 |
| Ch. 1121 | Antivirals, Oral Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/05/10 | 01-10-34
09-10-36
27-10-26
02-10-25
11-10-25
30-10-25
03-10-27
14-10-26
31-10-37
08-10-35
24-10-28
32-10-25 |
| Ch. 1121 | Macrolides/Ketolides Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/05/10 | 01-10-42
09-10-44
27-10-34
02-10-33
11-10-33
30-10-33
03-10-35
14-10-34
31-10-45
08-10-43
24-10-36
32-10-33 |
| Ch. 1121 | Antibiotics, Inhaled Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/05/10 | 01-10-30
09-10-32
27-10-22
02-10-21
11-10-21
30-10-21
03-10-23
14-10-22
31-10-33
08-10-31
24-10-24
32-10-21 |
| Ch. 1121 | Bone Resorption Suppression and Related Agents Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/05/10 | 01-10-30
09-10-32
27-10-22
02-10-21
11-10-21
30-10-21
03-10-23
14-10-22
31-10-33
08-10-31
24-10-24
32-10-21 |
| Ch. 1121 | Bile Salts Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/05/10 | 01-10-35
09-10-37
27-10-27
02-10-26
11-10-26
30-10-26
03-10-28
14-10-27
31-10-38
08-10-36
24-10-29
32-10-26 |
| Ch. 1121 | Antiparasitics, Topical Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/05/10 | 01-10-32
09-10-34
27-10-24
02-10-23
11-10-23
30-10-23
03-10-25
14-10-24
31-10-35
08-10-33
24-10-26
32-10-23 |
| Ch. 1121 | Cytokine and CAM Antagonists Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/05/10 | 01-10-38
09-10-40
27-10-30
02-10-29
11-10-29
30-10-29
03-10-31
14-10-30
31-10-41
08-10-39
24-10-32
32-10-29 |
| Ch. 1121 | Alzheimer's Agents Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/12/10 | 01-10-49
09-10-51
27-10-41
02-10-40
11-10-40
30-10-40
03-10-42
14-10-41
31-10-52
08-10-50
24-10-43
32-10-40 |
| Ch. 1121 | Ophthalmic Antibiotics Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/12/10 | 01-10-44
09-10-46
02-10-35
11-10-35
30-10-35
03-10-37
14-10-36
31-10-47
08-10-45
24-10-38
32-10-35 |
| Ch. 1121 | Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Handbook Pages—Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/12/10 | 01-10-43
09-10-45
27-10-35
02-10-34
11-10-34
30-10-34
03-10-36
14-10-35
31-10-46
08-10-44
24-10-37
32-10-34 |
| Ch. 1101
1121 | Requirement for Prescribing Provider
National Provider Identifier (NPI) Number on Outpatient Pharmacy Claims—Pharmacy Services | 11/12/10 | 99-10-13 |
| Ch. 1121 | Cephalosporins Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/12/10 | 01-10-48
09-10-50
27-10-40
02-10-39
11-10-39
30-10-39
03-10-41
14-10-40
31-10-51
08-10-49
24-10-42
32-10-39 |
| Ch. 1121 | Stimulants and Related Agents Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/12/10 | 01-10-47
09-10-49
27-10-39
02-10-38
11-10-38
30-10-38
03-10-40
14-10-39
31-10-50
08-10-48
24-10-41
32-10-38 |
| Ch.1121 | Platelet Aggregation Inhibitors Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/12/10 | 01-10-46
09-10-48
27-10-38
02-10-37
11-10-37
30-10-37
03-10-39
14-10-38
31-10-49
08-10-47
24-10-40
32-10-37 |
| Ch. 1121 | Ophthalmic Anti-Inflammatories Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 11/12/10 | 01-10-45
09-10-47
27-10-37
02-10-36
11-10-36
30-10-36
03-10-38
14-10-37
31-10-48
08-10-46
24-10-39
32-10-36 |
| Ch. 1129 | Dental Encounter payment for Dental Services Rendered by Rural Health Clinics and Federally Qualified Health Centers | 11/15/10 | 08-10-50 |
| Ch. 1245
1187 | Payment for Non-Emergency Transportation Services | 11/24/10 | 03-10-43
26-10-01 |
| Ch. 1121 | Incretin Mimetic/Enhancer Hypoglycemics Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update | 12/01/10 | 01-10-50
09-10-51
27-10-42
02-10-41
11-10-42
30-10-41
03-10-44
14-10-42
31-10-53
08-10-51
24-10-44
32-10-41 |
| Ch. 1101 | Missed Appointments | 12/01/10 | 99-10-14 |
| Ch. 1101
1150
1241 | Medical Assistance Program Coverage of the 2010-2011 Influenza Vaccines | 12/01/10 | 99-10-16 |
| Ch. 1121 | Oral Buprenorphine Agents Updated Handbook Pages—Pharmacy Services | 12/13/10 | 01-10-51
09-10-52
27-10-42
02-10-42
11-10-42
30-10-42
03-10-45
14-10-43
31-10-54
08-10-52
24-10-45
32-10-42 |
| Ch. 1121 | Hypoglycemics, TZDs Updated Handbook Pages Pharmacy Services | 12/20/10 | 01-10-52
09-10-53
27-10-43
02-10-43
11-10-43
30-10-43
03-10-46
14-10-44
31-10-55
08-10-53
24-10-46
32-10-43 |
| Ch. 1121 | Prior Authorization of Topamax/Topiramate Oral Anticonvulsants Updated Handbook Pages Pharmacy Services | 12/24/10 | 01-10-53
09-10-54
27-10-44
02-10-44
11-10-44
30-10-44
03-10-47
14-10-45
31-10-56
08-10-54
24-10-47
32-10-44 |
| Ch. 1121 | Prior Authorization of Methadone in Analgesics, Narcotic Long Acting Updated Handbook Pages Pharmacy Services | 12/24/10 | 01-10-54
09-10-55
27-10-45
02-10-45
11-10-45
30-10-45
03-10-48
14-10-46
31-10-57
08-10-55
24-10-48
32-10-45 |
| — | Complex Case Planning | 12/28/10 | 00-10-02 |
| 2011 | Ch. 1150 | 2010 HCPCS Updates and Other Procedure Code and Procedure Code/Modifier Combination Changes | 01/03/11 | 99-11-01 |
| Ch. 1123 | Change in Billing of Repairs and Replacements for Durable Medical Equipment | 01/14/11 | 24-11-01 |
| Ch. 1101
1150 | Medical Assistance Electronic Health Records (EHR) Incentive Program for Eligible Professionals | 01/25/11 | 08-11-02
09-11-01
27-11-01
31-11-01
33-11-01 |
| Ch. 1101
1150 | Medical Assistance Electronic Health Records (EHR) Incentive Program for Eligible Hospitals | 01/28/11 | 01-11-01 |
| Ch. 1225 | Rescind MA Program Fee Increase for Oral Contraceptives Dispensed by Family Planning Clinics | 02/09/11 | 08-11-03 |
| Ch. 1241 | 2011 Recommended Childhood and Adolescent Immunization Schedules | 03/18/11 | 01-11-04
08-11-06
09-11-05
31-11-05
33-11-04 |
| Ch. 1101
1150 | MA Program Outpatient Fee Schedule Decrease for Select Incontinence Products | 04/05/11 | 24-11-02
25-11-02 |
| — | Electronic Prescribing Internet-based Application for Enrolled Medicaid Prescribers | 04/08/11 | 03-11-01
09-11-02
14-11-01
18-11-01
24-11-03
27-11-02
31-11-02
33-11-03 |
| Ch. 1150 | Health Care Benefit Package 12 Updated Employability Assessment Procedure Code List | 04/13/11 | 01-11-02
08-11-04
09-11-03
18-11-02
28-11-01
29-11-01
31-11-03 |
| Ch. 1101 | Select Plan for Women Program—Update to Covered Services | 04/13/11 | 01-11-03
08-11-05
09-11-04
24-11-04
28-11-02
31-11-04
33-11-03 |
| Ch. 1101
1150 | Medical Assistance Electronic Health Record (EHR) Incentive Program Application Process for Eligible Professionals (EP) | 05/13/11 | 08-11-07
09-11-06
27-11-03
31-11-06
33-11-05 |
| Ch. 1101
1150 | Medical Assistance Electronic Health (EHR) Incentive Program Application Process for Eligible Hospitals | 05/13/11 | 01-11-05 |
| Ch. 1121 | Prior Authorization of Androgenic Agents—Pharmacy Services | 05/26/11 | 01-11-06
09-11-07
27-11-04
02-11-01
11-11-01
30-11-01
03-11-02
14-11-02
31-11-07
08-11-08
24-11-05
32-11-01 |
| Ch. 1121 | Prior Authorization of Angiotensin Modulators—Pharmacy Services | 05/26/11 | 01-11-10
09-11-11
27-11-08
02-11-05
11-11-05
30-11-05
03-11-06
14-11-06
31-11-11
08-11-12
24-11-09
32-11-05 |
| Ch. 1121 | Prior Authorization of Antidepressants, SSRIs—Pharmacy Services | 05/26/11 | 01-11-08
09-11-09
27-11-06
02-11-03
11-11-03
30-11-03
03-11-04
14-11-04
31-11-09
08-11-10
24-11-07
32-11-03 |
| Ch. 1121 | Prior Authorization of Atypical Antipsychotics—Pharmacy Services | 05/26/11 | 01-11-09
09-11-10
27-11-07
02-11-04
11-11-04
30-11-04
03-11-05
14-11-05
31-11-10
08-11-11
24-11-08
32-11-04 |
| Ch. 1121 | Prior Authorization of Proton Pump Inhibitors (PPIs)—Pharmacy Services | 05/26/11 | 01-11-07
09-11-08
27-11-05
02-11-02
11-11-02
30-11-02
03-11-03
14-11-03
31-11-09
08-11-09
24-11-06
32-11-02 |
| Ch. 1150 | Revisions to the Medical Assistance Program Fee Schedule Rates for Select Services | 05/30/11 | 99-11-02 |
| Ch. 1121 | Prior Authorization of Multiple Sclerosis Agents—Pharmacy Services | 06/08/11 | 01-11-17 |
| Ch. 1121 | Prior Authorization of Antihyperuricemics—Pharmacy Services | 06/08/11 | 01-11-16
09-11-17
27-11-14
02-11-11
11-11-11
30-11-11
03-11-12
14-11-12
31-11-17
08-11-18
24-11-15
32-11-11 |
| Ch. 1121 | Prior Authorization of Anticoagulants—Pharmacy Services | 06/08/11 | 01-11-18
09-11-19
27-11-16
02-11-13
11-11-13
30-11-13
03-11-14
14-11-14
31-11-19
08-11-20
24-11-17
32-11-13 |
| Ch. 1121 | Prior Authorization of Cymbalta Handbook Pages—Pharmacy Services | 06/08/11 | 01-11-18
09-11-19
27-11-16
02-11-13
11-11-13
30-11-13
03-11-14
14-11-14
31-11-19
08-11-20
24-11-17
32-11-13 |
| Ch. 1121 | Prior Authorization of Tysabri—Pharmacy Services | 06/08/11 | 01-11-13
09-11-14
27-11-11
02-11-08
11-11-08
30-11-08
03-11-09
14-11-09
31-11-14
08-11-15
24-11-12
32-11-08 |
| Ch. 1121 | Prior Authorization of Xolair—Pharmacy Services | 06/08/11 | 01-11-15
09-11-16
27-11-13
02-11-10
11-11-10
30-11-10
03-11-11
14-11-11
31-11-16
08-11-17
24-11-14
32-11-10 |
| Ch. 1121 | Compounded Hydroxyprogesterone Caproate (17-P)—Pharmacy Services | 06/08/11 | 01-11-19
09-11-20
27-11-17
02-11-14
11-11-14
30-11-14
03-11-15
14-11-15
31-11-20
08-11-21
24-11-18
32-11-14 |
| Ch. 1121 | Prior Authorization of Duplicate Therapy—Pharmacy Services | 06/08/11 | 01-11-20
09-11-21
27-11-18
02-11-15 |
| Ch. 1121 | Prior Authorization of Makena—Pharmacy Services | 06/21/11 | 01-11-11
09-11-12
27-11-09
02-11-06
11-11-06
30-11-06
03-11-07
14-11-07
31-11-12
08-11-13
24-11-10
32-11-06 |
| Ch. 1121 | Prior Authorization of Nuedexta—Pharmacy Services | 06/21/11 | 01-11-12
09-11-13
27-11-10
02-11-07
11-11-07
30-11-07
03-11-08
14-11-08
31-11-12
08-11-14
24-11-11
32-11-07 |
| Ch. 1121 | Anticoagulants Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-40
09-11-41
27-11-38
02-11-35
11-11-35
30-11-35
03-11-36
14-11-36
31-11-41
08-11-42
24-11-11
32-11-35 |
| Ch. 1121 | Angiotensin Modulators Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-39
09-11-40
27-11-37
02-11-34
11-11-34
30-11-34
03-11-35
14-11-35
31-11-40
08-11-41
24-11-38
32-11-34 |
| Ch. 1121 | Opiate Dependence Treatments (Formerly Oral Buprenorphine Agents) Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-34
09-11-35
27-11-32
02-11-29
11-11-29
30-11-29
03-11-30
14-11-30
31-11-35
08-11-36
24-11-33
32-11-29 |
| Ch. 1121 | Bladder Relaxant Preparations Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-14
09-11-25
27-11-22
02-11-19
11-11-19
30-11-19
03-11-20
14-11-20
31-11-25
08-11-26
24-11-23
32-11-19 |
| Ch. 1121 | Platelet Aggregation Inhibitors Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-38
09-11-39
27-11-36
02-11-33
11-11-33
30-11-33
03-11-34
14-11-34
31-11-39
08-11-40
24-11-37
32-11-33 |
| Ch. 1121 | Cephalosporins and Related Agents Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-26
09-11-27
27-11-24
02-11-21
11-11-21
30-11-21
03-11-22
14-11-22
31-11-27
08-11-28
24-11-25
32-11-21 |
| Ch. 1121 | Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-29
09-11-30
27-11-27
02-11-24
11-11-24
30-11-24
03-11-25
14-11-25
31-11-30
08-11-31
24-11-28
32-11-24 |
| Ch. 1121 | Pulmonary Arterial Hypertension Agents, Oral and Inhaled Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-30
09-11-31
27-11-28
02-11-25
11-11-25
30-11-25
03-11-26
14-11-26
31-11-31
08-11-32
24-11-29
32-11-25 |
| Ch. 1121 | Prior Authorization of Growth Hormones—Pharmacy Services | 07/14/11 | 01-11-42
09-11-43
27-11-40
02-11-37
11-11-37
30-11-37
03-11-38
14-11-38
31-11-43
08-11-44
24-11-41
32-11-25 |
| Ch. 1121 | Bone Resorption Suppression and Related Agents Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-32
09-11-33
27-11-30
02-11-27
11-11-27
30-11-27
03-11-28
14-11-28
31-11-33
08-11-34
24-11-31
32-11-27 |
| Ch. 1121 | Multiple Sclerosis Agents Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-41
09-11-42
27-11-39
02-11-36
11-11-36
30-11-36
03-11-37
14-11-37
31-11-42
08-11-43
24-11-40
32-11-36 |
| Ch. 1121 | Preferred Drug List (PDL) Update August 2011—Pharmacy Services | 07/14/11 | 01-11-37
09-11-38
27-11-35
02-11-32
11-11-32
30-11-32
03-11-33
14-11-33
31-11-38
08-11-39
24-11-36
32-11-32 |
| Ch. 1121 | Preferred Drug List (PDL) Update August 2011—Pharmacy Services | 07/14/11 | 01-11-35
09-11-36
27-11-33
02-11-30
11-11-30
30-11-30
03-11-31
14-11-31
31-11-36
08-11-37
24-11-34
32-11-32 |
| Ch. 1121 | Phosphate Binders Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-35
09-11-36
27-11-33
02-11-30
11-11-30
30-11-30
03-11-31
14-11-31
31-11-36
08-11-37
24-11-36
32-11-30 |
| Ch. 1121 | Analgesics, Narcotics Short Acting Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-23
09-11-24
27-11-21
02-11-18
11-11-18
30-11-18
03-11-19
14-11-19
31-11-24
08-11-25
24-11-22
32-11-18 |
| Ch. 1121 | Angiotensin Modulator Combinations Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-31
09-11-32
27-11-29
02-11-26
11-11-26
30-11-26
03-11-27
14-11-27
31-11-32
08-11-33
24-11-30
32-11-26 |
| Ch. 1121 | HIV/AIDS Medications Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-22
09-11-23
27-11-20
02-11-17
11-11-17
30-11-17
03-11-18
14-11-18
31-11-23
08-11-24
24-11-21
32-11-17 |
| Ch. 1121 | Antifungals, Topical Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-25
09-11-26
27-11-23
02-11-20
11-11-20
30-11-20
03-11-21
14-11-21
31-11-26
08-11-27
24-11-24
32-11-17 |
| Ch. 1121 | Incretin Memetic/Enhancer Hypoglycemics Handbook Pages—
Pharmacy Services | 07/14/11 | 01-11-33
09-11-34
27-11-31
02-11-28
11-11-28
30-11-28
03-11-29
14-11-29
31-11-34
08-11-35
24-11-32
32-11-28 |
| Ch. 1121 | Oral Contraceptives Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-28
09-11-29
27-11-26
02-11-23
11-11-23
30-11-23
03-11-24
14-11-24
31-11-29
08-11-30
24-11-27
32-11-23 |
| Ch. 1121 | Prenatal Vitamins Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-36
09-11-37
27-11-34
02-11-31
11-11-31
30-11-31
03-11-32
14-11-32
31-11-87
08-11-38
24-11-35
32-11-31 |
| Ch. 1121 | Colony Stimulating Factors Handbook Pages—Pharmacy Services | 07/14/11 | 01-11-27
09-11-28
27-11-25
02-11-22
11-11-22
30-11-22
03-11-23
14-11-23
31-11-28
08-11-29
24-11-26
32-11-22 |
| Ch. 1121 | Antiemetics (Promethazine)—Pharmacy Service | 07/19/11 | 01-11-21
09-11-22
27-11-19
02-11-16
11-11-16
30-11-16
03-11-17
14-11-17
31-11-22
08-11-23
24-11-20
32-11-16 |
| Ch. 1121 | Correction to Preferred Drug List (PDL) Update August 2011—Pharmacy Services | 08/08/11 | 01-11-45
02-11-39
03-11-40
08-11-46
09-11-45
11-11-39
14-11-40
24-11-46
27-11-42
30-11-39
31-11-44
32-11-39
33-11-07 |
| Ch. 1121 | Procedures to Submit Requests for Prior Authorization of Selected Medications by Facsimile (Fax)—Pharmacy Services | 08/08/11 | 01-11-46
02-11-40
11-11-40
30-11-40
09-11-46
27-11-43
03-11-41
14-11-41
31-11-45
08-11-47
24-11-47
32-11-40
33-11-08 |
| Ch. 1150 | 2011 HCPCS Updates and Other Procedure Code Changes | 08/08/11 | 00-11-04 |
| Ch. 1101 | Provider Screening of Employees and Contractors for Exclusion from Participation in Federal Health Care Programs and the Effect of Exclusion on Participation | 08/15/11 | 99-11-05 |
| Ch. 1121 | Prior Authorization of Synagis—Pharmacy Services | 08/15/11 | 01-11-47
09-11-47
27-11-44
02-11-41
11-11-41
30-11-41
03-11-42
14-11-42
31-11-46
08-11-48
24-11-48
32-11-41
33-11-09 |
| Ch. 1121 | Early Refills—Pharmacy Services | 08/15/11 | 01-11-47
09-11-47
27-11-44
02-11-41
11-11-41
30-11-41
03-11-42
14-11-42
31-11-46
08-11-48
24-11-48
32-11-41
03-11-09 |
| — | Specialty Pharmacy Drug Program
—Updated List of Covered Drugs
—Pharmacy Services | 09/09/11 | 99-11-60 |
| Ch. 1149 | Medical Assistance Dental Benefit Changes | 09/26/11 | 27-11-47
08-11-51 |
| Ch. 1163 | Revised Payment Policy for Hospital Readmissions | 10/03/11 | 01-11-44 |
| — | Discontinued Mailing of Medical Assistance Bulletins | 09/26/11 | 99-11-08 |
| Ch. 1150 | Prudent Payment of Claims | 09/30/11 | 99-11-07 |
| Ch. 1163 | Revised Payment Policy for Hospital Readmission | 09/30/11 | 01-11-44 |
| Ch. 1121 | Prior Authorization of Stimulants and Related Agents—Pharmacy Services | 10/17/11 | 01-11-48
09-11-48
27-11-45
02-11-42
11-11-42
30-11-42
03-11-43
14-11-43
31-11-47
08-11-49
24-11-49
32-11-42
33-11-10 |
| Ch. 1121 | Prior Authorization of Xyrem—Pharmacy Services | 10/17/11 | 01-11-49
09-11-49
27-11-46
02-11-43
11-11-43
30-11-43
03-11-44
14-11-44
31-11-48
08-11-50
24-11-50
32-11-43
33-11-11 |
| — | 5010/D.0 Instructions to be Ready for Electronic Transaction Upgrades | 10/27/11 | 99-11-09 |
| Ch. 1121 | Prior Authorization of Benzodiazepines—Pharmacy Services | 10/28/11 | 01-11-50 |
| Ch. 1121 | Prior Authorization of Skeletal Muscle Relaxants—Pharmacy Services | 10/28/11 | 01-11-50
09-11-50
27-11-48
02-11-44
11-11-44
30-11-44
03-11-45
14-11-45
31-11-49
08-11-52
24-11-51
32-11-44
33-11-12 |
| Ch. 1121 | Prior Authorization of Early Refills Exemptions and Automated Approvals—Pharmacy Services | 11/02/11 | 01-11-53
09-11-53
27-11-51
02-11-47
11-11-48
30-11-47
03-11-48
14-11-48
31-11-52
08-11-55
24-11-54
32-11-47
33-11-15 |
| Ch. 1150 | Announcing the Federally Mandated Implementation of the National Correct Coding Initiative (NCCI) in the Pennsylvania Department of Public Welfare's Medical Assistance Program | 11/10/11 | 99-11-10 |
| Ch. 1150 | ClaimCheck® Claims Criteria—Update | 11/23/11 | 99-11-11 |
| Ch. 1101
1150 | Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2 for Eligible Professionals (EP) | 12/02/11 | 08-11-56
09-11-54
27-11-52
31-11-53
33-11-16 |
| Ch. 1101
1150 | Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2 for Eligible Hospitals (EH) | 12/02/11 | 01-11-54 |
| Ch. 1121 | Prior Authorization of Anticoagulants—Pharmacy Services | 12/03/11 | 01-11-57
09-11-57
27-11-55
33-11-19
02-11-50
11-11-51
30-11-50
03-11-51
14-11-51
31-11-56
08-11-59
24-11-57
32-11-50 |
| Ch. 1121 | Prior Authorization of Erythropoiesis Stimulating Agents—Pharmacy Services | 12/03/11 | 01-11-56
09-11-56
27-11-54
33-11-18
02-11-49
11-11-50
30-11-49
03-11-50
14-11-50
31-11-55
08-11-58
24-11-56
32-11-49 |
| Ch. 1121 | Prior Authorization of Antipsychotics—Pharmacy Services | 12/09/11 | 01-11-52
09-11-52
27-11-50
02-11-46
11-11-46
30-11-46
03-11-47
14-11-47
31-11-51
08-11-54
24-11-53
32-11-46
33-11-14 |
| Ch. 1121 | Prior Authorization of Hepatitis C Agents—Pharmacy Services | 12/10/11 | 01-11-55
09-11-55
27-11-53
33-11-17
02-11-48
11-11-49
30-11-48
03-11-49
14-11-49
31-11-54
08-11-57
24-11-55
32-11-48 |
| Ch. 1121 | Medical Assistance Pharmacy Benefit Package Change | 12/30/11 | 99-11-58
14-11-52
18-11-03
24-11-58
27-11-56
31-11-57
33-11-20 |
| 2012 | Ch. 1121 | Prior Authorization of Antidepressants, Other—Pharmacy Services | 01/26/12 | 01-12-02
09-12-02
27-12-02
33-12-02
02-12-02
11-12-02
30-12-02
03-12-02
14-12-02
31-12-02
08-12-02
24-12-02
32-12-02 |
| Ch. 1121 | Prior Authorization of Antihypertensives, Sympatholytic—Pharmacy Services | 01/26/12 | 01-12-04
08-12-04
14-12-04
30-12-04
33-12-04
02-12-04
09-12-04
24-12-04
31-12-04
03-12-04
11-12-04
27-12-04
32-12-04 |
| Ch. 1121 | Prior Authorization of Antihistamines, Minimally Sedating—Pharmacy Services | 01/26/12 | 01-12-03
09-12-03
27-12-03
33-12-03
02-12-03
11-12-03
30-12-03
03-12-03
14-12-03
31-12-03
08-12-03
24-12-03
32-12-03 |
| Ch. 1121 | Preferred Drug List (PDL) Update February 2012—Pharmacy Services | 01/26/12 | 01-12-01
09-12-01
27-12-01
33-12-01
02-12-01
11-12-01
30-12-01
03-12-01
14-12-01
31-12-01
08-12-01
24-12-01
32-12-01 |
| Ch. 1121 | Prior Authorization of Cymbalta—Pharmacy Services | 01/26/12 | 01-12-06
09-12-06
27-12-06
33-12-06
02-12-06
11-12-06
30-12-06
03-12-06
14-12-06
31-12-06
08-12-06
24-12-06
32-12-06 |
| Ch. 1121 | Prior Authorization of Bronchodilators, Beta Agonists—Pharmacy Services | 01/26/12 | 01-12-05
09-12-05
27-12-05
33-12-05
02-12-05
11-12-05
30-12-05
03-12-05
14-12-05
31-12-05
08-12-05
24-12-05
32-12-05 |
| Ch. 1121 | Prior Authorization of Emollients—Pharmacy Services | 01/30/12 | 01-12-08
09-12-08
27-12-08
33-12-08
02-12-08
11-12-08
30-12-08
03-12-08
14-12-08
31-12-08
08-12-08
24-12-08
32-12-08 |
| Ch. 1121 | Prior Authorization of Antipsychotics—Pharmacy Services | 01/30/12 | 01-12-07
09-12-07
27-12-07
33-12-07
02-12-07
11-12-07
30-12-07
03-12-07
14-12-07
31-12-07
08-12-07
24-12-07
32-12-07 |
| Ch. 1121 | Prior Authorization of Intranasal Rhinitis Agents—Pharmacy Services | 02/01/12 | 01-12-11
09-12-11
27-12-11
33-12-11
02-12-11
11-12-11
30-12-11
03-12-11
14-12-11
31-12-11
08-12-11
24-12-11
32-12-11 |
| Ch. 1121 | Prior Authorization of Enzyme Replacements, Gauchers Disease—Pharmacy Services | 02/01/12 | 01-12-09
08-12-09
14-12-09
30-12-09
33-12-09
02-12-09
09-12-09
24-12-09
31-12-09
03-12-09
11-12-09
27-12-09
32-12-09 |
| Ch. 1121 | Prior Authorization of Immunomodulators, Atopic Dermatitis—Pharmacy Services | 02/01/12 | 01-12-10
08-12-10
14-12-10
30-12-10
33-12-10
02-12-10
09-12-10
24-12-10
31-12-10
03-12-10
11-12-10
27-12-10
32-12-10 |
| Ch. 1121 | Prior Authorization of Iron, Parenteral—Pharmacy Services | 02/01/12 | 01-12-12
08-12-12
14-12-12
30-12-12
33-12-12
02-12-12
09-12-12
24-12-12
31-12-12
03-12-12
11-12-12
27-12-12
32-12-12 |
| Ch. 1121 | Prior Authorization of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)—Pharmacy Services | 02/03/12 | 01-12-15
09-12-15
27-12-15
33-12-15
02-12-15
11-12-15
30-12-15
03-12-15
14-12-15
31-12-15
08-12-15
24-12-15
32-12-15 |
| Ch. 1121 | Prior Authorization of Myalgia and Neuropathy Agents—Pharmacy Services | 02/03/12 | 01-12-14
08-12-14
14-12-14
30-12-14
33-12-14
02-12-14
09-12-14
24-12-14
31-12-14
03-12-14
11-12-14
27-12-14
32-12-14 |
| Ch. 1121 | Prior Authorization of Sedative Hypnotics—Pharmacy Services | 02/06/12 | 01-12-19
09-12-19
27-12-19
33-12-19
02-12-19
11-12-19
30-12-19
03-12-19
14-12-19
31-12-19
08-12-19
24-12-19
32-12-19 |
| Ch. 1121 | Prior Authorization of Botulinum Toxins—Pharmacy Services | 02/06/12 | 01-12-13
09-12-13
27-12-13
33-12-13
02-12-13
11-12-13
30-12-13
03-12-13
14-12-13
31-12-13
08-12-13
24-12-13
32-12-13 |
| Ch. 1121 | Prior Authorization of Stimulants and Related Agents—Pharmacy Services | 02/06/12 | 01-12-21
09-12-21
27-12-21
33-12-21
02-12-21
11-12-21
30-12-21
03-12-21
14-12-21
31-12-21
08-12-21
24-12-21
32-12-21 |
| Ch. 1121 | Prior Authorization of Otic Anti-Infectives and Anesthetics—Pharmacy Services | 02/13/12 | 01-12-18
08-12-18
14-12-18
30-12-18
33-12-18
02-12-18
09-12-18
24-12-18
31-12-18
03-12-18
11-12-18
27-12-18
32-12-18 |
| Ch. 1121 | Prior Authorization of Ophthalmic Antibiotic-Steroid Combinations—Pharmacy Services | 02/13/12 | 01-12-17
08-12-17
14-12-17
30-12-17
33-12-17
02-12-17
09-12-17
24-12-17
31-12-17
03-12-17
11-12-17
27-12-17
02-12-17 |
| Ch. 1121 | Prior Authorization of Smoking Cessation Products—Pharmacy Services | 02/14/12 | 01-12-20
09-12-20
27-12-20
03-12-20
02-12-20
11-12-20
30-12-20
03-12-20
14-12-20
31-12-20
08-12-20
24-12-20
32-12-20 |
| Ch. 1128 | Processing of Medicare Renal Dialysis Services Crossover Claims for Procedure Code 90999 | 02/21/12 | 30-12-22 |
| Ch. 1101
1150 | Correction to Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2 for Eligible Professionals (EP) | 03/08/12 | 08-12-22
09-12-24
27-12-22
31-12-22
33-12-22 |
| Ch. 1121 | Prior Authorization of Myalgia and Neuropathy Agents—Pharmacy Services | 03/18/12 | 01-12-22
09-12-23
27-12-23
33-12-23
02-12-22
11-12-22
30-12-23
03-12-22
14-12-22
31-12-23
08-12-23
24-12-22
32-12-22 |
| Ch. 1121 | Prior Authorization of Antibiotics, Topical—Pharmacy Services | 03/18/12 | 01-12-24
09-12-25
27-12-24
33-12-25
02-12-23
11-12-23
30-12-24
03-12-23
14-12-23
31-12-25
08-12-25
24-12-23
32-12-23 |
| Ch. 1123 | Removal of NU Pricing Modifier from Procedure Codes for Oxygen Contents | 03/20/12 | 24-12-24
25-12-01 |
| Ch. 1121 | Prior Authorization of Oncology Agents, Oral—Pharmacy Services | 04/02/12 | 01-12-16
09-12-16
27-12-16
33-12-16
02-12-16
11-12-16
30-12-16
03-12-16
14-12-16
31-12-16
08-12-16
24-12-16
32-12-16 |
| — | Provider Electronic Solutions (PES) Software v3.59 replaces v3.58 | 04/06/12 | 99-12-01 |
| Ch. 1101
Ch. 1150
Ch. 1241 | Updates to the Medical Assistance Program Fee Schedule for the Administration of Prevnar 13® Vaccine | 04/06/12 | 01-12-25
08-12-26
09-12-26
31-12-26
33-12-26 |
| Ch. 1101 | Updates to Medical Assistance Copayment Policy | 04/16/12 | 99-12-03 |
| Ch. 1121 | Changes to the Drug Cost Component of Payment for Brand Name and Generic Drugs—Pharmacy Services | 05/01/12 | 01-12-28
09-12-29
27-12-26
33-12-28
02-12-25
11-12-25
30-12-26
03-12-25
14-12-25
31-12-29
08-12-28
24-12-26
32-12-25 |
| Ch. 1121 | Changes to the Dispensing Fee Component of Payment for Brand Name and Generic Drugs—Pharmacy Services | 05/01/12 | 01-12-27
09-12-28
27-12-25
33-12-27
02-12-24
11-12-24
30-12-25
03-12-24
14-12-24
31-12-24
08-12-27
24-12-25
32-12-24 |
| Ch. 1149 | Revision of Online Training Module for the Application of Topical Fluoride Varnish | 05/01/12 | 09-12-27
31-12-27 |
| Ch. 1163 | Newborn Payment Policy for Acute Care General Hospitals | 05/04/12 | 01-12-26 |
| — | Specialty Pharmacy Drug Program—Updated List of Covered Drugs—Pharmacy Services | 05/11/12 | 99-12-04 |
| — | Electronic Forms | 05/11/12 | 99-12-02 |
| Ch. 1121 | Prior Authorization of Makena—Pharmacy Services | 05/11/12 | 01-12-29
02-12-26
03-12-26
08-12-29
09-12-30
11-12-26
14-12-26
24-12-27
27-12-27
30-12-27
31-12-30
32-12-26
33-12-29 |
| Ch. 1150 | Consultations Performed Using Telemedicine | 05/23/12 | 09-12-31
31-12-31
33-12-30 |
| Ch. 1229 | HealthChoices Physical Health Managed Care Expansion | 05/25/12 | 99-12-05 |
| — | Provider Preventable Conditions | 06/15/12 | 01-12-30
03-12-27
09-12-32
18-12-01
31-12-32
33-12-31
02-12-27
08-12-30
14-12-27
27-12-28
32-12-27
47-12-01 |
| — | FQHC Change in Scope of Service | 06/20/12 | 08-12-31 |
| Ch. 1150 | 2012 HCPCS Updates and Other Procedure Code Changes | 06/25/12 | 99-12-06 |
| Ch. 1121 | Prior Authorization of Incretin Mimetic/Enhancers Hypoglycemics—Pharmacy Services | 07/11/12 | 01-12-32
09-12-34
27-12-30
33-12-33
02-12-29
11-12-28
30-12-29
03-12-29
14-12-29
31-12-34
08-12-33
24-12-29
32-12-29 |
| Ch. 1121 | Preferred Drug List (PDL) Update August 2012—Pharmacy Services | 07/12/12 | 01-12-33
09-12-35
27-12-31
33-12-34
02-12-30
11-12-29
30-12-37
03-12-30
14-12-30
31-12-35
08-12-34
24-12-30
32-12-30 |
| Ch. 1121 | Prior Authorization of Opiate Dependence Treatments—Pharmacy Services | 07/13/12 | 01-12-36
08-12-36
14-12-31
30-12-31
33-12-35
02-12-31
09-12-37
24-12-32
31-12-37
03-12-31
11-12-30
27-12-33
32-12-31 |
| Ch. 1121 | Prior Authorization of Platelet Aggregation Inhibitors—Pharmacy Services | 08/03/12 | 01-12-45
09-12-43
27-12-39
33-12-41
02-12-37
11-12-36
30-12-37
03-12-37
14-12-37
31-12-43
08-12-42
24-12-38
32-12-37 |
| Ch. 1121 | Prior Authorization of Pituitary Suppressive Agents, LHRH—Pharmacy Services | 08/03/12 | 01-12-44
09-12-42
27-12-38
33-12-40
02-12-36
11-12-35
30-12-36
03-12-36
14-12-36
31-12-42
08-12-41
24-12-37
32-12-36 |
| Ch. 1121 | Prior Authorization of Benign Prostatic Hyperplasia (BPH) Treatments—Pharmacy Services | 08/03/12 | 01-12-41
09-12-40
27-12-36
33-12-38
02-12-34
11-12-33
30-12-34
03-12-34
14-12-34
31-12-40
08-12-39
24-12-35
32-12-34 |
| Ch. 1121 | Prior Authorization of Erythropoiesis Stimulating Proteins—Pharmacy Services | 08/03/12 | 01-12-42
09-12-41
27-12-37
33-12-39
02-12-35
11-12-34
30-12-35
03-12-35
14-12-35
31-12-41
08-12-40
24-12-36
32-12-35 |
| Ch. 1121 | Prior Authorization of Antibiotics, GI—Pharmacy Services | 08/03/12 | 01-12-39
09-12-38
27-12-34
33-12-36
02-12-32
11-12-31
30-12-32
03-12-32
14-12-32
31-12-38
08-12-37
24-12-33
32-12-32 |
| Ch. 1121 | Prior Authorization of Anticoagulants—Pharmacy Services | 08/03/12 | 01-12-40
09-12-39
27-12-35
33-12-37
02-12-33
11-12-32
30-12-33
03-12-33
14-12-33
31-12-39
08-12-38
24-12-34
32-12-33 |
| Ch. 1121 | Prior Authorization of Lipotropics, Statins—Pharmacy Services | 08/03/12 | 01-12-46
09-12-44
27-12-40
33-12-42
02-12-38
11-12-37
30-12-38
03-12-38
14-12-37
31-12-44
08-12-43
24-12-39
32-12-38 |
| Ch. 1121 | Prior Authorization of Growth Factors—Pharmacy Services | 08/07/12 | 01-12-31
08-12-32
14-12-28
30-12-28
33-12-32
02-12-28
09-12-33
24-12-28
31-12-33
03-12-28
11-12-27
27-12-29
32-12-28 |
| Ch. 1229 | HealthChoices Physical Health Managed Care New West Zone Expansion | 08/08/12 | 99-12-08 |
| Ch. 1101
Ch. 1150 | Medical Assistance Program Fee Schedule Revisions | 08/31/12 | 99-12-10 |
| Ch. 1150 | Information Regarding Peritoneal Dialysis Treatment | 09/13/12 | 01-12-50
30-12-43
31-12-49 |
| Ch. 1101
Ch. 1150 | Medical Assistance Program Fee Schedule Changes for Renal Dialysis Services | 09/13/12 | 30-12-39
13-12-45 |
| Ch. 1121 | Prior Authorization of Hepatitis C Agents—Pharmacy Services | 09/13/12 | 01-12-49
09-12-47
27-12-43
33-12-45
02-12-41
11-12-40
30-12-42
03-12-41
14-12-41
31-12-48
08-12-46
24-12-42
32-12-41 |
| Ch. 1121 | Prior Authorization of Cytokine and CAM Antagonists—Pharmacy Services | 09/13/12 | 01-12-48
09-12-46
27-12-42
33-12-44
02-12-40
11-12-39
30-12-41
03-12-40
14-12-40
31-12-47
08-12-45
24-12-41
32-12-40 |
| Ch. 1121 | Prior Authorization of Bronchodilators, Anticholinergic—Pharmacy Services | 09/13/12 | 01-12-47
09-12-45
27-12-41
33-12-43
02-12-39
11-12-38
30-12-40
03-12-39
14-12-39
31-12-46
08-12-44
24-12-40
32-12-39 |
| Ch. 1150 | New Procedure Codes for Tobacco Cessation Counseling Services | 10/03/12 | 99-12-09 |
| Ch. 1101 | Delaying Alternative Cost Sharing for Families of Children with Disabilities with Incomes Over 200% |
of the Federal Poverty Income Guidelines
10/15/12 | 99-12-15
| | Ch. 1121 | Prior Authorization of Botulinum Toxins—Pharmacy Services | 10/22/12 | 01-12-53
09-12-50
27-12-46
33-12-48
02-12-44
11-12-43
30-12-46
03-12-44
14-12-44
31-12-52
08-12-49
24-12-45
32-12-44 |
| Ch. 1121 | Prior Authorization of Angiotensin Modulator Combinations—Pharmacy Services | 10/22/012 | 01-12-52
02-12-43
03-12-43
08-12-48
09-12-49
11-12-42
14-12-43
24-12-44
27-12-45
30-12-45
31-12-51
32-12-43
33-12-47 |
| Ch. 1150 | Federally Mandated Implementation: Updates to National Correct Coding Initiative (NCCI) | 10/26/12 | 99-12-12 |
| Ch. 1121 | Prior Authorization of Angiotensin Modulators—Pharmacy Services | 10/30/12 | 01-12-54
08-12-50
14-12-45
30-12-47
33-12-49
02-12-45
09-12-51
24-12-46
31-12-53
03-12-45
11-12-44
27-12-47
32-12-45 |
| Ch. 1121 | Prior Authorization of Multiple Sclerosis Agents—Pharmacy Services | 10/30/12 | 01-12-56
08-12-52
14-12-47
30-12-49
33-12-51
02-12-47
09-12-53
24-12-48
31-12-55
03-12-47
11-12-46
27-12-49
32-12-47 |
| Ch. 1121 | Prior Authorization of Tysabri—Pharmacy Services | 10/30/12 | 01-12-57
08-12-53
14-12-48
30-12-50
33-12-52
02-12-48
09-12-54
24-12-49
31-12-56
03-12-48
11-12-47
27-12-50
32-12-48 |
| Ch. 1121 | Prior Authorization of Incretin Mimetic/Enhancer Hypoglycemics—Pharmacy Services | 10/30/12 | 01-12-55
08-12-51
14-12-46
30-12-48
33-12-50
02-12-46
09-12-52
24-12-47
31-12-54
03-12-46
11-12-45
27-12-48
32-12-46 |
| Ch.1123 | Prior Authorization Requirements for the Rental of Medical Appliances and Durable Medical Equipment | 12/10/12 | 24-12-55
25-12-02 |
| Ch. 1101
Ch. 1150 | Medical Assistance Program Fee Schedule Revisions | 12/10/12 | 99-12-13 |
| Ch. 1101
Ch. 1150
Ch. 1149 | Addition to the Medical Assistance Program Fee Schedule for Administration of Flu Vaccine for Intradermal Use: Fluzone Intradermal® | 12/13/12 | 01-12-64
08-12-59
09-12-60
31-12-62
33-12-58 |
| Ch. 1150 | NPI Requirements on All Claim Submission Media | 12/19/12 | 99-12-14 |
| Ch. 1121 | Anticoagulants—New Quantity Limit for Low Molecular Weight Heparins and Arixtra (Fondaparinux)—Pharmacy Services | 12/21/12 | 01-12-63
09-12-59
27-12-55
33-12-57
02-12-53
11-12-52
30-12-55
03-12-53
14-12-53
31-12-61
08-12-58
24-12-54
32-12-53 |
| Ch. 1121 | Prior Authorization of Kalydeco—Pharmacy | 12/21/12 | 01-12-60
09-12-56
27-12-52
33-12-54
02-12-50
11-12-49
30-12-52
03-12-50
14-12-50
31-12-58
08-12-55
24-12-51
32-12-50 |
| Ch. 1121 | Prior Authorization of Hypoglycemics, TZDs—Pharmacy Services | 12/21/12 | 01-12-61
09-12-57
27-12-53
33-12-55
02-12-51
11-12-50
30-12-53
03-12-51
14-12-51
31-12-59
08-12-56
24-12-52
32-12-51 |
| Ch. 1121 | Prior Authorization of Antipsychotics—Pharmacy Services | 12/21/12 | 01-12-62
09-12-58
27-12-54
33-12-56
02-12-52
11-12-51
30-12-54
03-12-52
14-12-52
31-12-60
08-12-57
24-12-53
32-12-52 |
| Ch. 1121 | Prior Authorization of Korlym—Pharmacy Services | 12/21/12 | 01-12-59
09-12-55
27-12-51
33-12-53
02-12-49
11-12-48
30-12-51
03-12-49
14-12-49
31-12-57
08-12-54
24-12-50
32-12-49 |
| Ch. 1150 | Clinical Laboratory Improvement Amendments Requirements | 12/28/12 | 01-12-67
08-12-62
09-12-63
28-12-01
31-13-65
33-13-61 |
| 2013 | Ch. 1121 | Prior Authorization of Antipsoriatics Topical—Pharmacy Services | 01/07/13 | 01-13-01
09-13-01
27-13-01
33-13-01
02-13-01
11-13-01
30-13-01
03-13-01
14-13-01
31-13-01
08-13-01
24-13-01
32-13-01 |
| Ch. 1121 | Prior Authorization of Antipsychotics—Pharmacy Services | 01/07/13 | 01-13-02
09-13-02
27-13-02
33-13-02
02-13-02
11-13-02
30-13-02
03-13-02
14-13-02
31-13-02
08-13-02
24-13-02
32-13-02 |
| Ch. 1121 | Prior Authorization of Diabetic Strips—Pharmacy Services | 01/07/13 | 01-13-03
09-13-03
27-13-03
33-13-03
02-13-03
11-13-03
30-13-03
03-13-03
14-13-03
31-13-03
08-13-03
24-13-03
32-13-03 |
| Ch. 1121 | Prior Authorization of Glucocorticoids Oral—Pharmacy Services | 01/07/13 | 01-13-04
09-13-04
27-13-04
33-13-04
02-13-04
11-13-04
30-13-04
03-13-04
14-13-04
31-13-04
08-13-04
24-13-04
32-13-04 |
| Ch. 1121 | Prior Authorization of Leukotriene Modifiers—Pharmacy Services | 01/07/13 | 01-13-05
09-13-05
27-13-05
33-13-05
02-13-05
11-13-05
30-13-05
03-13-05
14-13-05
31-13-05
08-13-05
24-13-05
32-13-05 |
| Ch. 1121 | Prior Authorization of Neuropathic Pain Agents (Formerly Myalgia and Neuropathy Agents)—Pharmacy Services | 01/07/13 | 01-13-06
09-13-06
27-13-06
33-13-06
02-13-06
11-13-06
30-13-06
03-13-06
14-13-06
31-13-06
08-13-06
24-13-06
32-13-06 |
| Ch. 1121 | Prior Authorization of Oncology Agents Breast Cancer—Pharmacy Services | 01/07/13 | 01-13-07
08-13-07
14-13-07
32-13-07
02-13-07
09-13-07
24-13-07
30-13-07
03-13-07
11-13-07
27-13-07
31-13-07
33-13-07 |
| Ch. 1121 | Prior Authorization of Smoking Cessation Products—Pharmacy Services | 01/07/13 | 01-13-08
09-13-08
27-13-08
33-13-08
02-13-08
11-13-08
30-13-08
03-13-08
14-13-08
31-13-08
08-13-08
24-13-08
32-13-08 |
| Ch. 1121 | Prior Authorization of Diabetic Meters—Pharmacy Services | 01/07/13 | 01-13-09
09-13-09
27-13-09
33-13-09
02-13-09
11-13-09
30-13-09
03-13-09
14-13-09
31-13-09
08-13-09
24-13-09
32-13-09 |
| Ch. 1229 | HealthChoices Physical Health Managed Care New East Zone Expansion | 01/18/13 | 99-13-02 |
| Ch. 1121 | Preferred Drug List (PDL) Update January 15, 2013—Pharmacy Services | 01/22/13 | 01-13-11
09-13-11
27-13-11
33-13-11
02-13-10
11-13-10
30-13-10
03-13-10
14-13-10
31-13-12
08-13-11
24-13-11
32-13-10 |
| Ch. 1150 | Medical Assistance Program Fee Increase for Select Primary Care Services and Physician Attestation Form | 01/22/13 | 31-13-11 |
| Ch. 1121 | Prior Authorization of Cytokine and CAM Antagonists—Pharmacy Services | 01/25/13 | 01-13-12
08-13-12
14-13-11
30-13-11
33-13-12
02-13-11
09-13-12
24-13-12
31-13-13
03-13-11
11-13-11
27-13-12
32-13-11 |
| Ch. 1150 | Medical Assistance Program Fee Increase for Select Primary Care Services and Physician Attestation Form | 01/22/13 | 31-13-11 |
| Ch. 1101
Ch. 1150 | Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2013 for Eligible Professionals (EP) | 02/01/13 | 08-13-10
09-13-10
27-13-10
31-13-10
33-13-10 |
| Ch. 1101
Ch. 1150 | Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2013 for Eligible Hospitals (EH) | 02/01/13 | 01-13-10 |
| Ch. 1101 | Updated Procedures for Submitting the Deficit Reduction Act of 2005 Attestation Form | 02/14/13 | 99-13-04 |
| Ch. 1229 | Continued Existence of the Fee-For-Service Delivery System in HealthChoices Zones and Enrollment of Breast and Cervical Cancer Prevention and Treatment (BCCPT) Recipients in HealthChoices | 02/22/13 | 99-13-05 |
| Ch. 1121 | Prior Authorization of Analgesics Narcotic Short Acting—Pharmacy Services | 03/29/13 | 01-13-16
08-13-16
14-13-15
30-13-15
33-13-17
02-13-15
09-13-17
24-13-16
31-13-18
03-13-15
11-13-15
27-13-16
32-13-15 |
| Ch. 1121 | Prior Authorization of Bladder Relaxant Preparations—Pharmacy Services | 03/29/13 | 01-13-14
09-13-15
27-13-14
33-13-15
02-13-13
11-13-13
30-13-13
03-13-13
14-13-13
31-13-16
08-13-14
24-13-14
32-13-13 |
| Ch. 1121 | Prior Authorization of Bronchodilators Beta Agonists Short Acting Agents—Pharmacy Services | 03/29/13 | 01-13-17
08-13-17
14-13-16
30-13-16
33-13-18
02-13-16
09-13-18
24-13-17
31-13-19
03-13-16
11-13-16
27-13-17
32-13-16 |
| Ch. 1121 | Prior Authorization of Antipsychotics—Pharmacy Services | 03/29/13 | 01-13-13
08-13-13
14-13-12
30-13-12
33-13-14
02-13-12
09-13-14
24-13-13
31-13-15
03-13-12
11-13-12
27-13-13
32-13-12 |
| Ch. 1121 | Prior Authorization of Chronic Obstructive Pulmonary Disease (COPD) Agents—Pharmacy Services | 03/29/13 | 01-13-15
09-13-16
27-13-15
33-13-16
02-13-14
11-13-14
30-13-14
03-13-14
14-13-14
31-13-17
08-13-15
24-13-15
32-13-14 |
| Ch. 1101
Ch. 1150 | Medical Assistance Program Fee Schedule Revisions for Procedure Code K0606 | 04/01/13 | 24-13-10
25-13-01 |
| Ch. 1101
Ch. 1150 | Medical Assistance Program Fee Schedule Revisions | 04/15/13 | 99-13-03 |
| Ch. 1121 | Medical Assistance Pharmacy Benefit Package Update | 04/22/13 | 99-13-20
14-13-17
18-13-01
24-13-18
17-13-18
31-13-21
33-13-20 |
| | | | |
| Ch. 1121 | Prior Authorization of Anticoagulants—Pharmacy Services | 5/3/13 | 01-13-19
09-13-21
27-13-19
33-13-21
02-13-17
11-13-17
30-13-17
03-13-17
14-13-18
31-13-22
08-13-19
24-13-19
32-13-17 |
| Ch. 1101 | Revised Physician Attestation Form for Primary Care Services | 05/03/13 | 31-13-32 |
| Ch. 1121 | Prior Authorization of Pulmonary Arterial Hypertension (PAH) Agents Oral and Inhaled—Pharmacy Services | 05/03/13 | 01-13-23
09-13-25
27-13-23
33-13-25
02-13-21
11-13-21
30-13-21
03-13-21
14-13-22
31-13-26
08-13-23
24-13-23
32-13-21 |
| Ch. 1121 | Prior Authorization of Lyrica (pregabalin) Neuropathic Pain Agents and Oral Anticonvulsants—Pharmacy Services | 05/03/13 | 01-13-25
09-13-27
27-13-25
33-13-27
02-13-23
11-13-23
30-13-23
03-13-23
14-13-24
31-13-28
08-13-25
24-13-25
32-13-23 |
| Ch. 1121 | Prior Authorization of Multiple Sclerosis Agents—Pharmacy Services | 05/03/13 | 01-13-20
09-13-22
27-13-20
33-13-22
02-13-18
11-13-18
30-13-18
03-13-18
14-13-19
31-13-23
08-13-20
24-13-20
32-13-18 |
| Ch. 1121 | Prior Authorization of Botulinum Toxins (Type A and Type B)—
Pharmacy Services | 05/03/13 | 01-13-21
09-13-23
27-13-21
33-13-23
02-13-19
11-13-19
30-13-19
03-13-19
14-13-20
31-13-24
08-13-21
24-13-21
32-13-19 |
| Ch. 1121 | Prior Authorization of Benzodiazepines; Analgesics Narcotic Long Acting; and Analgesics Narcotic Short Acting—Pharmacy Services | 05/03/13 | 01-13-26
09-13-28
27-13-26
33-13-28
02-13-24
11-13-24
30-13-24
03-13-24
14-13-25
31-13-29
08-13-26
24-13-26
32-13-24 |
| Ch. 1121 | Medicare Part D Coverage of Barbiturates and Benzodiazepines—Pharmacy Services | 05/03/13 | 01-13-28
08-13-28
14-13-27
30-13-26
33-13-30
02-13-26
09-13-30
24-13-28
31-13-31
03-13-26
11-13-26
27-13-28
32-13-26 |
| Ch. 1121 | Prior Authorization of Cytokine and CAM Antagonists—Pharmacy Services | 05/03/13 | 01-13-27
09-13-29
27-13-27
33-13-29
02-13-25
11-13-25
30-13-25
03-13-25
14-13-26
31-13-30
08-13-27
24-13-27
32-13-25 |
| Ch. 1121 | 340B Drug Pricing Program Provider Requirements and Billing Instructions—Pharmacy Services | 05/16/13 | 99-13-08 |
| Ch. 1101 | Application of InvestiClaimTM Analytics to Select Claims | 05/17/13 | 99-13-09 |
| Ch. 1150 | Implementation of the Medical Assistance Program's Physician Fee Increases for Select Primary Care Services | 05/23/13 | 31-13-34 |
| Ch. 1150 | Addition to the Medical Assistance Program Fee Schedule for Administration of Flu Vaccine Derived from Cell Cultures: Flucelvax | 05/25/13 | 01-13-18
08-13-18
09-13-19
31-13-20
33-13-19 |
| Ch. 1121 | Prior Authorization of Androgenic Agents—Pharmacy Services | 05/31/13 | 01-13-22
02-13-20
03-13-20
08-13-22
09-13-24
11-13-20
14-13-21
24-13-22
27-13-22
30-13-20
31-13-25
32-13-20
33-13-24 |
| Ch. 1121 | Prior Authorization of H.P. Acthar Gel—Pharmacy Services | 05/31/13 | 01-13-24
02-13-22
03-13-22
08-13-24
09-13-26
11-13-22
14-13-23
24-13-24
27-13-24
30-13-22
31-13-27
32-13-22
33-13-26 |
| Ch. 1150 | 2013 HCPCS Updates and Other Procedure Code Changes | 06/24/13 | 99-13-07 |
| Ch. 1121 | Prior Authorization of Anticoagulants—Pharmacy Services | 07/02/13 | 01-13-38
02-13-34
03-13-34
08-13-36
09-13-38
11-13-34
14-13-35
24-13-36
27-13-36
30-13-34
31-13-42
32-13-34
33-13-38 |
| Ch. 1121 | Prior Authorization of Antiparasitics Topical—Pharmacy Services | 07/02/13 | 01-13-37
02-13-33
03-13-33
08-13-35
09-13-37
11-13-33
14-13-34
24-13-35
27-13-35
30-13-33
31-13-41
32-13-33
33-13-37 |
| Ch. 1121 | Prior Authorization of Multiple Sclerosis Agents—Pharmacy Services | 07/02/13 | 01-13-39
02-13-35
03-13-35
08-13-37
09-13-39
11-13-35
14-13-36
24-13-37
27-13-37
30-13-35
31-13-43
32-13-35
33-13-39 |
| Ch. 1150 | Hospital Payment Arrangements 1 and 2 for Emergency Room Services | 07/02/13 | 01-13-29
31-13-33 |
| Ch. 1121 | Prior Authorization of Vasodilators Coronary—Pharmacy Services | 07/02/13 | 01-13-36
02-13-32
03-13-32
08-13-34
09-13-36
11-13-32
14-13-33
24-13-34
27-13-34
30-13-32
31-13-40
32-13-32
33-13-36 |
| Ch. 1121 | Prior Authorization of Incretin Mimetic/Enhancer Hypoglycemics—Pharmacy Services | 07/02/13 | 01-13-34
02-13-30
03-13-30
08-13-32
09-13-34
11-13-30
14-13-31
24-13-32
27-13-32
30-13-30
31-13-38
32-13-30
33-13-34 |
| Ch. 1121 | Prior Authorization of H. Pylori Treatments—Pharmacy Services | 07/02/13 | 01-13-32
02-13-28
03-13-28
08-13-30
09-13-32
11-13-28
14-13-29
24-13-30
27-13-30
30-13-28
31-13-36
32-13-28
33-13-32 |
| Ch. 1121 | Preferred Drug List (PDL) Update July 24, 2013—Pharmacy Services | 07/07/13 | 01-13-31
09-13-31
27-13-29
33-13-31
02-13-27
11-13-27
30-13-27
03-13-27
14-13-28
31-13-35
08-13-29
24-13-29
32-13-27 |
| Ch. 1121 | Prior Authorization of Colony Stimulating Factors—Pharmacy Services | 07/13/13 | 01-13-33
09-13-33
27-13-31
33-13-33
02-13-29
11-13-29
30-13-29
03-13-29
14-13-30
31-13-37
08-13-31
24-13-31
32-13-29 |
| Ch. 1121 | Prior Authorization of Irritable Bowel Syndrome Agents—Pharmacy Services | 07/13/13 | 01-13-35
09-13-35
27-13-33
33-13-35
02-13-31
11-13-31
30-13-31
03-13-31
14-13-32
31-13-39
08-13-33
24-13-33
32-13-31 |
| Ch. 1121 | Prior Authorization of Acne Agents Oral—Doxycycline—Pharmacy Services | 07/22/13 | 01-13-40
08-13-38
14-13-37
30-13-36
33-13-40
02-13-36
09-13-40
24-13-38
31-13-44
03-13-36
11-13-36
27-13-38
32-13-36 |
| Ch. 1127
Ch. 1150 | Changes to the Payment Structure for Birth Center Services | 08/29/13 | 09-13-13
31-13-14
33-13-13
47-13-01 |
| Ch. 1101 | Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2014 for Eligible Hospitals (EH) | 09/20/13 | 01-13-41 |
| Ch. 1101 | Implementation of ADA Claim Form—Version 2012 and Elimination of ADA Claim Form—Version 2006 | 09/20/13 | 17-13-01
19-13-01
20-13-01
27-13-39
31-13-45 |
| Ch. 1101
Ch. 1149
Ch. 1129 | Correction to the Procedures for Reporting of Other Provider Preventable Conditions (OPPCs) for Federally Qualified Health Centers Rural Health Clinics and Dentists | 10/02/13 | 08-13-39
27-13-41 |
| Ch. 1101 | Application of InvestiClaimTM Analytics to Select Claims—Update | 10/04/13 | 99-13-12 |
| Ch. 1121 | Prior Authorization of Anticoagulants—Pharmacy Services | 11/04/13 | 01-13-45
09-13-45
27-13-45
33-13-44
02-13-40
11-13-40
30-13-40
03-13-40
14-13-41
31-13-50
08-13-43
24-13-42
32-13-40 |
| Ch. 1121 | Prior Authorization of Angiotensin Modulators—Pharmacy Services | 11/04/13 | 01-13-44
09-13-44
27-13-44
33-13-43
02-13-39
11-13-39
30-13-39
03-13-39
14-13-40
31-13-49
08-13-42
24-13-41
32-13-39 |
| Ch. 1121 | Prior Authorization of Benign Prostatic Hyperplasia (BPH) Treatment—Pharmacy Services | 11/04/13 | 01-13-46
09-13-46
27-13-46
33-13-45
02-13-41
11-13-41
30-13-41
03-13-41
14-13-42
31-13-51
08-13-44
24-13-43
32-13-41 |
| Ch. 1121 | Prior Authorization of HIV/AIDS Medications—Pharmacy Services | 11/04/13 | 01-13-47
09-13-47
27-13-47
33-13-46
02-13-42
11-13-42
30-13-42
03-13-42
14-13-43
31-13-52
08-13-45
24-13-44
32-13-42 |
| Ch. 1121 | Prior Authorization of Alzheimer's Agents—Pharmacy Services | 11/04/13 | 01-13-42
09-13-42
27-13-42
33-13-41
02-13-37
11-13-37
30-13-37
03-13-37
14-13-38
31-13-47
08-13-40
24-13-39
32-13-37 |
| Ch. 1121 | Prior Authorization of Leukotriene Modifiers—Pharmacy Services | 11/04/13 | 01-13-48
09-13-48
27-13-48
33-13-47
02-13-43
11-13-43
30-13-43
03-13-43
14-13-44
31-13-53
08-13-46
24-13-45
32-13-43 |
| Ch. 1121 | Prior Authorization of Angiotensin Modulator Combinations—Pharmacy Services | 11/04/13 | 01-13-43
09-13-43
27-13-43
33-13-42
02-13-38
11-13-38
30-13-38
03-13-38
14-13-39
31-13-48
08-13-41
24-13-40
32-13-38 |
| Ch. 1121 | Prior Authorization of Antipsychotics—Pharmacy Services | 11/22/13 | 01-13-52
09-13-50
27-13-49
33-13-49
02-13-44
11-13-44
30-13-44
03-13-44
14-13-45
31-13-57
08-13-49
24-13-46
32-13-44 |
| Ch. 1121 | Prior Authorization of Analgesics
Narcotic Long Acting Analgesics
Narcotic Short Acting and Cough and Cold Medications—Pharmacy Services | 11/22/13 | 01-13-55
09-13-53
27-13-52
33-13-52
02-13-47
11-13-47
30-13-47
03-13-47
14-13-48
31-13-60
08-13-52
24-13-49
32-13-47 |
| Ch. 1121 | Prior Authorization of Vecamyl (mecamylamine)—Pharmacy Services | 11/22/13 | 01-13-54
09-13-52
27-13-51
33-13-51
02-13-46
11-13-46
30-13-46
03-13-46
14-13-47
31-13-59
08-13-51
24-13-48
32-13-46 |
| Ch. 1121 | Prior Authorization of Lipotropics Other—Pharmacy Services | 11/22/13 | 01-13-53
09-13-51
27-13-50
33-13-50
02-13-45
11-13-45
30-13-45
03-13-45
14-13-46
31-13-58
08-13-50
24-13-47
32-13-45 |
| Ch. 1101 | CAQH CORE Federal Mandate: Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) | 11/22/13 | 99-13-14 |
| Ch. 1101 | Presumptive Eligibility as Determined by Hospitals | 12/06/13 | 01-13-56 |
| Ch. 1121 | Preferred Drug List (PDL) Update January 22, 2014—Pharmacy Services | 12/18/13 | 01-13-57
02-13-48
03-13-48
08-13-53
09-13-54
11-13-48
14-13-49
24-13-50
27-13-53
30-13-48
31-13-61
32-13-48
33-13-53 |
| Ch. 1150 | Medical Assistance Program Fee Schedule Revisions | 12/27/13 | 99-13-13 |
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