Anti-COVID19 - Commercial

Quantity Limit

Topical Lidocaine - Medicaid

Prior Authorization, Quantity Limit

Topical Lidocaine - Commercial

Prior Authorization, Quantity Limit

Topical Doxepin - Medicaid

Prior Authorization, Quantity Limit

Topical Doxepin - Commercial

Prior Authorization, Quantity Limit

Sunosi (solriamfetol) - Medicaid

Prior Authorization, Quantity Limit

Sunosi (solriamfetol) - Commercial

Prior Authorization, Quantity Limit

P58-21 2022 Renewal Changes Summary for Institutional Providers

P54-21 Updated Minnesota Health Care Programs and Minnesota Senior Health Options (MSHO) Prior Authorization and Medical Policy Requirements

P56-21 New Medical, Medical Drug and Behavioral Health Policy Management Updates—Effective December 6, 2021