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What's New in Pharmacy

 Recent Changes to Clinical Prior Authorization (PA) Critera: 

  • Antiemetics (5HT3 Blockers): No PA required for children <15 years of age
  • Antihistamines, Minimally Sedating: No clinical criteria
  • Long-Acting Beta Agonists: No clinical criteria
  • Leukotriene Modifiers: No clinical criteria
  • Proton Pump Inhibitors: No clinical criteria for once daily therapy
  • Stimulants: No diagnosis required for children age 18 or younger
(PDL requirements still exist)
  
Atypical Antipsychotics
Effective immediately, Idaho Medicaid is implementing the Preferred Drug List (PDL) for the Atypical Antipsychotics. The state is adopting recommendations of the Pharmacy and Therapeutics (P&T) Committee at the time of its original clinical review of this drug class. The Committee will review the class again as part of the August 2009 TOP$ review. The addition of this class to the PDL is being taken in accordance with the governor's mandated one percent budget cut (Executive Order 2008-03). As always, careful consideration has been, and will continue to be given towards ensuring Idaho Medicaid recipients have access to clinically efficacious, safe and cost-effective medications.
 
Idaho Medicaid Awarded Academic Detailing Grant
The Idaho Medicaid pharmacy program has been awarded a $50,000 grant to fund an academic detailing pilot program. The program, which will operate during the 2009 calendar year in southwest and south central Idaho, will provide targeted educational outreach to prescribers of mental health medications. Click Here to read more. 
Prior Authorization Request Forms
 Title
A Universal Form - Can't find the form you need?
ACE Inhibitors
Acne Topical
Actiq
Advair
Age Override Form
Aldara
Alzheimer's Agents
Amitiza
Analgesics, Topical
Androgenic Agents
Angiotensin Modulators-Channel Blockers
Anti Parkinson Agents
Antiacne Agents, Topical
Antibiotics, Otic (For The Ear)
Antidepressants, Other
Antidepressants, SSRI
Antiemetics. Oral
Antiepileptic Agents for Pain and Mood Disorderss
Antiepileptics
Antifungals for Onychomycosis, Oral
Antifungals, Topical
Antihistamine, Minimally Sedating
Antihyperuricemics, Oral
Antivirals, Topical
ARB - Angiotensin II Receptor Antagonists
Benzaclin/DUAC
Benzamyacin
Beta Blocker
Beta-2 Agonists, Inhaled
Bone Resorption & Suppression
Brand Name
Byetta
Carbamazepine, Extended Release
Cephalosporins and Related Antibiotics, Oral
Clindamycin Pledgetts
COX-2
Cymbalta
Emend
Emsam
EPSDT
Erythromycin Pledgetts
Erythropoiesis Stimulating Proteins
Fentora
Fluoroquinolones, Oral
Fluoroquinolones, Otic (for the Ear)
Glucocorticoids, Inhaled
Growth Hormone
Hepatitis C Agents-Interferons
Hepatitis C Agents-Ribavirin
Insulins (Short Acting Only)
Intranasal Rhinitis Agents
Klonopin Wafers
Leukotrienes
Lipotropics, Other
Macrolides-Ketolides, Oral
Marinol
MedWatch Form (PDF)
Narcotics Analgesic Long Acting
Narcotics Short Acting
NSAIDS
Ophthalmic Antibiotics
Ophthalmics for Allergic Conjunctivitis
Ophthalmics, Fluroquinolone and Macrolides
Pancreatic Enzymes
Platelet Aggregation Inhibitors
Proton Pump Inhibitors (PPI)
Provigil (modafanil)
Prozac Weekly
Quantity Override
Regranex
Retinoids, Oral
Sedative Hypnotics
Skeletal Muscle Relaxants
Statins
Stimulants
Strattera
Symbicort
Symlin
Synagis
Tekturna
Triptan
Uloric
Urinary Incontinence
Vytorin
Xanax XR
Xenical
Xolair
Zetia
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