...necessity, investigational and experimental services. The following policies have moved to the Pharmacy Policy page: Medicaid Drug Rebate Program (MDRP) Coverage Rules – AC Reject Medical Necessity – Off Label...

...Prior Authorization Needed? Preferred Drug List Drugs Yes $3 copay generic, compound and sole source drugs. $10 copay brand-name drugs. Prior authorization is needed for some drugs that require step...

...and make a healthy home. Medication Assisted Treatment (MAT) MAT helps ease cravings for drugs or alcohol and has two parts. One part is prescription medicine. It is used in...

...talk about what treatment may help you most. Detoxification (detox) Care that helps you withdraw from alcohol and drugs. It can take from 3 to 10 days for your body...

...or drug use, depression or stress reduction, we can help. If you have any questions about what your plan covers or how to find a provider, call Member Services at...

...prescription drugs inconsistent with the order Submitting claims for a more expensive brand drug when a less expensive generic prescription is dispensed Dispensing less than the prescribed quantity without arranging...

...so, make sure these medicines are on the CareSource drug list. Check the drug list to see if they require approval from CareSource before they can be filled. Do you...

...Urine Drug Screening Prior Authorization Form – Submit this form when requesting prior authorization for urine drug screenings Submit the SUD 1115 Waiver Universal PA Form to request prior authorization...

...opioids to reduce risk of overdose Checklist for Prescribing Opioids for Chronic Pain – Checklist before prescribing opioids for chronic pain Prescription Drug Monitoring Programs (PDMP) – Guideline for prescribing...

...Part B benefits must be obtained at Medicare-certified facilities. Part D covered drugs dispensed at out-of-network pharmacies when enrollees cannot reasonably be expected to obtain covered Part D drugs at...