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Reduction Mammoplasty Commercial Pre-Authorization Request Form (Medical Policy IV-32) (PDF)
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P28R1-20 Update: Medical Oncology Drug Prior Authorization Updates for Fully Insured Commercial and Medicare Advantage Subscribers – eviCore Healthcare Specialty Utilization Management (UM) Program
Hnub Tim pib siv tau lub khoos kas: Lub Yim Hlis Ntuj Tim 03, 2020
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P57-20 Site of Service Program Updates for Selected Specialty Medical Drugs for Commercial Subscribers: Medical Policy XI-06
Hnub Tim pib siv tau lub khoos kas: Lub Yim Hlis Ntuj Tim 03, 2020
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QP77-20 Commercial Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Bempedoic Acid
Hnub Tim pib siv tau lub khoos kas: Lub Yim Hlis Ntuj Tim 26, 2020
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QP82-20 Commercial Pharmacy Benefit Exclusion for Amzeeq™ (minocycline) foam, brimonidine ophthalmic solution 0.15% and ProAir® (albuterol sulfate) HFA
Hnub Tim pib siv tau lub khoos kas: Lub Yim Hlis Ntuj Tim 26, 2020
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P40-20 New Medical, Medical Drug and Behavioral Health Policy Management Updates – Effective August 3, 2020
Hnub Tim pib siv tau ntawm lub khoos kas: Rau Hlis Ntuj Tim 01, 2020
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QP73-20 MHCP Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Bempedoic Acid PA with QL
Hnub Tim pib siv tau lub khoos kas: Lub Yim Hlis Ntuj Tim 12, 2020
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QP72-20 MHCP Pharmacy Benefit Update – Pharmacy Benefit Exclusion for Anjeso™, Fetroja®, Herzuma®, Ontruzant®, Potassium Phosphates, Scenesse® and Trazimera™
Hnub Tim pib siv tau lub khoos kas: Lub Yim Hlis Ntuj Tim 12, 2020
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QP71-20 MHCP Pharmacy Benefit Update: Pharmacy Benefit Exclusion for Phesgo™, Uplizna™, and Zepzelca™
Hnub Tim pib siv tau lub khoos kas: Lub Yim Hlis Ntuj Tim 12, 2020
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QP64R1-20 Medical Drug Update for New to Market Viltolarsen (Viltepso)
Hnub Tim pib siv tau lub khoos kas: Lub Yim Hlis Ntuj Tim 26, 2020