August 28, 2019

State of Alabama
Press Release: Medicaid

Preferred Drug List (PDL) Quarterly Update

PDF Version

 

TO:         Pharmacies, Physicians, Physician Assistants, Nurse Practitioners, Oral Surgeons, Optometrists, Dentists, FQHCs, RHCs, Mental Health Service Providers and Nursing Homes

 

 Effective October 1, 2019, the Alabama Medicaid Agency will:

 

1.    Include preferred fibric acid derivatives, alendronate tablets, amitriptyline tablets, azathioprine tablets, hydroxychloroquine tablets, methotrexate tablets, pioglitazone tablets, and trazodone tablets in the mandatory three-month supply program.

Prescriptions for three-month maintenance supply medications will not count toward the monthly prescription limit. A maintenance supply prescription will be required after 60 days’ stable therapy. Please see the website for a complete listing of maintenance supply medications.

 

2.    Include the Antigout Agents in the Preferred Drug List (PDL). 

 

3.    Require Prior Authorization (PA) for colchicine tablets.

 

4.    Update the PDL to reflect the quarterly updates. The updates are listed below: 

PDL Additions

Citranatal 90 DHA

Prenatal Vitamins

Citranatal Assure

Prenatal Vitamins

Citranatal B-Calm

Prenatal Vitamins

Citranatal DHA

Prenatal Vitamins

Citranatal Harmony

Prenatal Vitamins

Citranatal Rx

Prenatal Vitamins

Farxiga

Sodium-glucose Cotransport 2 Inhibitors

Humalog Mix

Insulins

Invokamet

Sodium-glucose Cotransport 2 Inhibitors

Invokana

Sodium-glucose Cotransport 2 Inhibitors

Jardiance

Sodium-glucose Cotransport 2 Inhibitors

Jentadueto

Dipeptidyl Peptidase-4 (DPP-4) Inhibitors

Mitigare

Antigout

Prempro

Estrogens

Tradjenta

Dipeptidyl Peptidase-4 (DPP-4) Inhibitors

PDL Deletions

Menest

Estrogens

Sklice

Scabicides and Pediculicides

 

 

For additional PDL and coverage information, visit our drug look-up site at https://www.medicaid.alabamaservices.org/ALPortal/NDC%20Look%20Up/tabId/39/Default.aspx.

 

The PA request form and criteria booklet should be utilized by the prescriber or the dispensing pharmacy when requesting a PA. The PA request form can be completed and submitted electronically on the Agency’s website at https://medicaid.alabama.gov/content/9.0_Resources/9.4_Forms_Library/9.4.13_Pharmacy_Forms.aspx.

 

Providers requesting PAs by mail or fax should send requests to:

 

Health Information Designs (HID)

Medicaid Pharmacy Administrative Services

P. O. Box 3210 Auburn, AL 36832-3210

Fax: 1-800-748-0116

Phone: 1-800-748-0130

 

Incomplete PA requests or those failing to meet Medicaid criteria will be denied. If the prescriber believes medical justification should be considered, the prescriber must document this on the form or submit a written letter of medical justification along with the PA form to HID. Additional information may be requested. Staff physicians will review this information.

 

Policy questions concerning this provider notice should be directed to the Pharmacy Program at (334) 242-5050. Questions regarding PA procedures should be directed to the HID help desk at 1-800-748-0130.



  • For more information, visit http://medicaid.alabama.gov
  • For more state-wide press releases, click here