Provider
QP62-22 Commercial Pharmacy Benefit Exclusion for Propel®, Propel Mini®, Sinuva®
Program effective Date: Jul 27, 2022
Documents & Forms Results
Displaying 2011 - 2020 of 3288 results
Provider
QP63-22 MHCP Pharmacy Benefit Update – New drug-related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Ryplazim® (plasminogen, human-tvmh)
Program effective Date: Jul 27, 2022
Provider
QP55-22 Commercial Pharmacy Benefit Update: New and Revised Drug-Related Prior Authorization (PA) Requirement Notification, Effective September 1, 2022
Program effective Date: Jul 13, 2022
Provider
QP56-22 MHCP Pharmacy Benefit Update – New drug-related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Cibinqo™ (abrocitinib)
Program effective Date: Jul 13, 2022
Provider
QP57-22 MHCP Pharmacy Benefit Update – New drug-related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Pyrukynd® (mitapivat)
Program effective Date: Jul 13, 2022
Provider
QP58-22 MHCP Pharmacy Benefit Update – New drug-related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Recorlev® (levoketoconazole)
Program effective Date: Jul 13, 2022
Provider
QP59-22 MHCP Pharmacy Benefit Update – New drug-related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Tarpeyo™ (budesonide)
Program effective Date: Jul 13, 2022
Provider
QP60-22 MHCP Pharmacy Benefit Exclusion for Camcevi™ (leuprolide)
Program effective Date: Jul 13, 2022
Provider
P37-22 Updated Minnesota Health Care Programs and Minnesota Senior Health Options (MSHO) Prior Authorization and Medical Policy Requirements
Program effective Date: Jul 01, 2022
Provider
P38-22 eviCore Healthcare Specialty Utilization Management (UM) Program: Musculoskeletal Clinical Guideline Updates
Program effective Date: Jul 01, 2022