Keyrx drug list alternatives master effECTIVE 1/1/2021
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Early Intensive Behavioral Intervention (EIBI) Services Pre-Authorization Request Form (PDF)
Provider
QP64-21 Patient360 Enhancement for Minnesota Health Care Programs Members
Program effective Date: Aug 11, 2021
Provider
QP62-21 Commercial Pharmacy Benefit Update – New and Revised Drug-Related Prior Authorization (PA) Requirement Notification – Effective October 1, 2021
Program effective Date: Aug 11, 2021
Provider
QP63-21 MHCP Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Empaveli (pegcetacoplan)
Program effective Date: Aug 11, 2021
Provider
QP65-21 Minnesota Health Care Programs Providers use of the Interactive Care Reviewer
Program effective Date: Aug 11, 2021
Provider
P45-21 Behavioral Health Coding for Early Intensive Behavioral Intervention and Applied Behavioral Analysis
Program effective Date: Aug 02, 2021
Provider
P44-21 Urine Drug Testing Reimbursement Policy
Program effective Date: Aug 02, 2021