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Prescription Drug Program Manual

Prescription Drug Program Manual

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Prescription Drug Program Manual

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Prescription Drug Program Manual

Updated 04/25/2017

This manual was updated 04/25/2017

Update Log

Update Log


Prescription Drug Program, July 2016: Cost Share Updates

Prescription Drug Program, January 2016: HELP Plan-Related Updates and Others

Prescription Drug Program, Prior Authorization, Reimbursement, and Billing Procedures

Prescription Drug Program, Entire Manual

Prescription Drug Program, Reimbursement

Prescription Drug Program, Entire Manual Including the New Passport Chapter
This set of replacement pages contains a terminology change ("client" to "member"); however, only content changes are marked with a change bar (black line).

Prescription Drug Program, Key Contacts and Reimbursement

Prescription Drug Program, Medicaid Covered Products

Prescription Drug Program, Multiple Chapters

Prescription Drug Program, Medicaid Covered Services and Reimbursement (Dispensing Fee) and MHSP Covered Products (Formulary Drugs)

Prescription Drug Program
Entire manual has changed from last posted version.

Prescription Drug Program, Updated Prescription Drug Prior Authorization Criteria

Prescription Drug Program, Prior Authorization and HIPAA Updates

Prior Authorization Additions

Table of Contents


Key Contacts


Drug Program


Medicaid Covered Products


MHSP Covered Products


Dispencing Limitations


Prior Authorization




Billing Procedures




Billing a Paper Claim


Appendix A: Forms


Definitions and Acronyms




Complete Prescription Drug Program Manual