pharmacy.medicaid.ohio.gov

News

Recent Communications

6/1/2022

30-Day Change Notice for Changes Effective July 1st, 2022 posted

5/31/2022

2022Q2 DUR Digest posted

5/17/2022

May 10, 2022 DUR Board Meeting Minutes posted

4/26/2022

May 10, 2022 DUR Board Meeting Agenda posted

4/15/2022

Unified Preferred Drug List effective 4-15-2022 posted

UPDL Criteria effective 4-15-2022 posted

Quantity Limits Document effective 4-15-2022 posted

Ohio Medicaid Preferred Diabetic Supply List effective 4/1/2022 posted

4/13/2022

April 6th P&T Committee Meeting Minutes posted

3/31/2022

UPDL Criteria effective 4-1-2022 posted

Unified Preferred Drug List effective 4-1-2022 posted

Updated Additional Therapeutic Classes with Clinical Criteria Document posted

New MCP Pharmacy Reference Guide posted

Updated Quantity Limits Document posted

Updated Prior Authorization and Step Therapy Frequently Asked Questions Document posted

Updated P&T By Laws posted

3/23/2022

April 6, 2022 P&T Committee Meeting Agenda posted

3/10/2022

30-Day Change Notice for Sublocade Changes Effective April 15th, 2022 posted

2/24/2022

30-Day Change Notice for Changes Effective April 1st, 2022 posted

2022 vol 18 DUR Digest posted

2/14/2022

February 8, 2022 DUR Board Meeting Minutes posted

1/25/2022

February 8, 2022 DUR Board Meeting Agenda posted

1/24/2022

Claims Review Provider Manual effective January 2022 posted

Updated Ohio Medicaid Preferred Diabetic Supply List effective 1/1/2022 posted

1/21/2022

COVID-19 At Home Test Provider Notice posted

1/19/2022

January 12th P&T Committee Meeting Minutes posted

1/7/2022

Ohio Medicaid Preferred Diabetic Supply List effective 1/1/2022 posted

12/30/2021

Updated Additional Therapeutic Classes with Clinical Criteria Document posted

New Hepatitis C Direct Acting Antiviral Prior Authorization form posted

New MCP Pharmacy Reference Guide posted

Unified Preferred Drug List effective 1-1-2022 posted

UPDL Criteria effective 1-1-2022 posted

12/29/2021

January 12, 2022 P&T Committee Meeting Agenda posted

12/20/2021

Updated P&T Committee Conflict of Interest Statement posted

Updated P&T Committee Interested Party Conflict of Interest Statement posted

Updated DUR Board Conflict of Interest Statement posted

11/30/2021

30-Day Change Notice for Changes Effective January 1st, 2022 posted

2021 vol 17 DUR Digest posted

11/15/2021

Discontinuing Submission Clarification Code 13 Provider Notice posted

2022 DUR Board Meeting Schedule posted

September 21, 2021 DUR Board Meeting Minutes posted

2022 P&T Committee Meeting Schedule posted

10/26/2021

November 9, 2021 DUR Board Meeting Agenda posted

10/20/2021

COVID-19 Vaccine Booster Administration Fee Provider Notice posted

Claims Payer Sheet Effective 10/19/2021 posted

10/13/2021

October 6th P&T Committee Meeting Minutes posted

10/1/2021

Updated Additional Therapeutic Classes with Clinical Criteria Document posted

MyCare Ohio and MCP Pharmacy Reference Guide posted

9/28/2021

September 21, 2021 DUR Board Meeting Minutes posted

9/9/2021

Claims Payer Sheet Effective 9/9/2021 posted

COVID-19 Vaccine Booster Administration Fee Provider Notice posted

9/7/2021

September 21, 2021 DUR Board Meeting Agenda posted

October 6, 2021 P&T Meeting Agenda posted

8/18/2021

Claims Review Provider Manual effective July 2021 posted

8/12/2021

2021 vol 16 DUR Digest posted

7/2/2021

The P&T Committee Meeting that was scheduled for July 14th, 2021 has been cancelled.

6/30/2021

Unified Preferred Drug List Effective 7/1/2021 posted

UPDL Criteria Effective 7/1/2021 posted

Updated Additional Therapeutic Classes with Clinical Criteria Document posted

Ohio Medicaid Preferred Diabetic Supply List effective 7/1/2021 posted

July 14th, 2021 P&T Meeting Agenda posted

6/22/2021

Claims Payer Sheet Effective 5/28/2021 posted

MyCare Ohio and MCP Pharmacy Reference Guide posted

6/14/2021

Updated Provider Manual posted

New OmniPod Insulin Pump Prior Authorization Form posted

6/11/2021

30-Day Change Notice for Changes Effective July 9th, 2021 posted

Updated MAC Request Form posted

5/28/2021

30-Day Change Notice for Changes Effective July 1st, 2021 posted

2021 vol 15 DUR Digest posted

Acceptable DAW Code Use Provider Notice posted

5/17/2021

May 11, 2021 DUR Board Meeting Minutes posted

5/7/2021

New Hepatitis C Direct Acting Antiviral Prior Authorization form posted

4/27/2021

COVID-19 Vaccine Increased Administration Fee Provider Notice posted

4/26/2021

May 11, 2021 DUR Board Meeting Agenda posted

4/20/2021

April 14th P&T Committee Meeting Minutes posted

3/31/2021

Unified Preferred Drug List Effective 4-1-2021 posted

UPDL Criteria Effective 4-1-2021 posted

Ohio Medicaid Preferred Diabetic Supply List effective 4-1-2021 posted

Updated Additional Therapeutic Classes with Clinical Criteria Document posted

Covered Active Pharmaceutical Ingredients and Excipients for Compounding effective 4-2-21 posted

3/22/2021

April 14th, 2021 P&T Meeting Agenda posted

MyCare Ohio and MCP Pharmacy Reference Guide posted

2/26/2021

30-Day Change Notice for Changes Effective April 1st, 2021 posted

2021 vol 14 DUR Digest posted

30-Day Change Notice for Active Pharmaceutical Compounding Ingredients and Excipients posted

2/16/2021

COVID-19 Vaccine Provider Notice posted

2/11//2021

February 9, 2021 DUR Board Meeting Minutes posted

1/22/2021

February 9, 2021 DUR Board Meeting Agenda posted

1/21/2021

COVID-19 Vaccine Provider Notice posted

1/20/2021

January 13th P&T Committee Meeting Minutes posted

1/19/2021

Claims Review Provider Manual effective January 2021 posted

1/15/2021

Claims Payer Sheet Effective 1/15/2021 posted

1/13/2021

2021 DUR Board Meeting Schedule posted

12/31/2020

Unified Preferred Drug List Effective 1/1/2021 posted

12/24/2020

2021 Ohio Medicaid Preferred Diabetic Supply List posted

Updated Additional Therapeutic Classes with Clinical Criteria Document posted

12/23/2020

MyCare Ohio and MCP Pharmacy Reference Guide posted

12/7/2020

2021 P&T Committee Meeting Schedule posted

11/30/2020

2020 Cost of Dispensing Survey posted

2020 vol 13 DUR Digest posted

30-Day Change Notice for Changes Effective January 1st, 2021 posted

11/18/2020

Updated Provider Manual posted

11/17/2020

Updated Additional Therapeutic Classes with Clinical Criteria document posted

Provider Notice Regarding FFS Pharmacy Helpdesk Hours posted

11/13/2020

November 10, 2020 DUR Board Meeting Minutes posted

11/11/2020

COVID-19 Point-of-Care Testing Payer Sheet Effective 11/6/2020 posted

10/27/2020

November 10, 2020 DUR Board Meeting Agenda posted

10/8/2020

Additional Therapeutic Classes with Clinical Criteria posted

P&T Committee Interested Party Conflict of Interest posted

10/7/2020

September 30, 2020 P&T Committee Meeting Minutes posted

10/2/2020

Additional Therapeutic Classes with Clinical Criteria posted

09/30/2020

Unified Preferred Drug List Effective 10-1-2020 posted

09/24/2020

September 22, 2020 DUR Board Meeting Minutes posted

09/18/2020

New MCP Pharmacy Reference Guide posted

09/17/2020

New Provider Manual posted

Claims Payer Sheet Effective 9/21/2020 posted

Quantity Prescribed Field Provider Notice posted

09/14/2020

New Hepatitis C Direct Acting Antiviral Prior Authorization form posted

09/9/2020

Additional Therapeutic Classes with Clinical Criteria posted

09/8/2020

September 22, 2020 DUR Board Meeting Agenda posted

09/2/2020

Additional Therapeutic Classes with Clinical Criteria posted

08/31/2020

30-Day Change Notice for Changes Effective October 1st, 2020 posted

September 30th, 2020 P&T Meeting Agenda posted

08/26/2020

2020 vol 12 DUR Digest posted

Updated Hepatitis C Direct Acting Antiviral Prior Authorization form posted

08/19/2020

COVID-19 Webpage added

08/17/2020

Quantity Limits Document posted

08/11/2020

Interested Party Conflict of Interest Statement posted

08/7/2020

COVID-19 Testing Pharmacy Billing Memo posted

07/29/2020

ODM Pharmacy Claims Review Provider Manual July 2020 posted

07/21/2020

DUR Board Conflict of Interest posted

07/15/2020

Approved January 15th, 2020 P&T Meeting Minutes posted

July 8th, 2020 P&T Meeting Minutes posted

Updated P&T By Laws posted

07/10/2020

Updated Provider Manual posted

07/2/2020

COVID-19 Specimen Collection Payer Sheet Effective 7/2/2020 posted

06/24/2020

July 8th 2020 P&T Agenda posted

06/22/2020

COVID-19 Specimen Collection Payer Sheet Effective 6/22/2020 posted

06/19/2020

Updated 2020 MyCare Ohio and MCP Pharmacy Reference Guide posted

05/15/2020

May 12, 2020 DUR Board Meeting Minutes posted

2020 vol 11 DUR Digest posted

04/28/2020

May 12, 2020 DUR Board Meeting Agenda posted

04/27/2020

Pharmacy Industry Day Application posted

04/20/2020

Updated Prior Authorization Forms published

03/31/2020

UPDL Effective 4/1/2020 published

03/16/2020

The P&T Committee Meeting that was scheduled for April 15th, 2020 has been cancelled.

03/02/2020

Updated Additional Therapeutic Classes with Clinical Criteria Document posted

02/24/2020

30 Day Change Notice posted

02/18/2020

Updated 2020 MyCare Ohio and MCP Pharmacy Reference Guide posted

02/13/2020

February 11, 2020 DUR Board Meeting Minutes posted

02/05/2020

2020 vol 10 DUR Digest posted

01/31/2020

UPDL Effective 1/1/2020 Published.

01/27/2020

February 11, 2020 DUR Board Agenda posted.

01/24/2020

Revised 2020 Ohio Medicaid Preferred Supply List posted.

01/22/2020

January 15, 2020 P&T Minutes posted.

01/08/2020

January 15th, 2020 Revised P&T Agenda posted.

01/03/2020

Press Release: Ohio Medicaid Launches Unified Preferred Drug List

01/01/2020

UPDL Effective 1/1/2020 Published.

2020 MyCare Ohio and MCP Pharmacy Reference posted

2020 Ohio Medicaid Preferred Supply List posted

12/19/2019

PDL Effective 1/1/2020 Published.

12/16/2019

January 15th, 2020 P&T Agenda posted

11/27/2019

January 1st, 2020 Changes posted

11/19/2019

November 12, 2019 DUR Board Minutes posted

The UPDL Webpage has been published

2019 vol 9 DUR Digest posted

11/08/2019

PDL Effective 1/1/2020 Published.

News Release: Ohio Medicaid Finalizes Unified Preferred Drug List

10/16/2019

November 15th Changes posted

Prior Authorization and Step Therapy Frequently Asked Questions Document posted

10/09/2019

October 2, 2019 P&T Minutes posted

10/03/2019

The Unified Preferred Drug List (PDL) Announcement posted

PDL Effective 10/1/2019 Published

09/23/2019

September 17, 2019 DUR Board Minutes posted

09/19/2019

Draft Unified PDL posted

09/05/2019

October 1st Changes posted

08/30/2019

October 2nd, 2019 P&T agenda posted.

September 17, 2019 DUR Board Agenda posted.

08/20/2019

2019 vol 8 DUR Digest posted.

07/17/2019

Pharmacy Claims Review Provider Manual July 2019 posted.

07/12/2019

July 10, 2019 P&T Minutes posted.

06/14/2019

2019 MyCare Ohio and MCP Pharmacy Reference posted.

05/31/2019

Information regarding July 1st changes posted.

05/23/2019

2019 vol 7 DUR Digest posted.

05/20/2019

May 14, 2019 DUR Board Minutes posted.

04/26/2019

May 14, 2019 DUR Board Agenda posted.

04/15/2019

April 10, 2019 P&T Minutes posted.

03/01/2019

Information regarding April 1st changes posted.

02/01/2019

Information regarding the Coordinated Services Program posted.

01/31/2019

Pharmacy Claims Review Provider Manual January 2019 posted.

01/28/2019

February 12th, 2019 DUR Board agenda posted.

01/03/2019

2019 vol 6 DUR Digest posted.

01/01/2019

Updated Provider Manual and new Omnipod PA form posted

11/30/2018

Information regarding UPDL initiative delayed indefinitely posted.

11/30/2018

2018 Cost of Dispensing Survey posted.

11/30/2018

Information regarding January 1st changes posted.

11/20/2018

November 13th, 2018 DUR Board draft meeting minutes posted.

11/02/2018

PDL Effective 1/1/2019 Published.

10/30/2018

DUR Committee membership updated.
November 13th, 2018 DUR Board agenda posted.
Unified Preferred Drug List (PDL) provider memorandum posted.

10/10/2018

October 3, 2018 P&T Minutes posted.

10/04/2018

2018 vol 5 DUR Digest posted.

08/31/2018

October 3rd, 2018 P&T agenda posted.

08/23/2018

September 11th, 2018 DUR Board agenda posted.

08/17/2018

ODM Pharmacy Claims Review Provider Manual July 2018 posted.

08/02/2018

2018 vol 4 DUR Digest posted.

07/03/2018

2018 vol 3 DUR Digest posted.

06/15/2018

July 11, 2018 P&T Agenda posted.

06/01/2018

Updated information regarding July 1st changes posted.

05/29/2018

2018 vol 2 DUR Digest posted.

05/15/2018

February 6th, 2018 DUR Board final meeting minutes posted.
May 8th, 2018 DUR Board draft meeting minutes posted.
Updated MyCare Ohio and MCP Pharmacy Reference Guide posted.

04/24/2018

May 8th, 2018 DUR Board draft meeting minutes posted.

04/18/2018

April 11, 2018 P&T Minutes posted.

03/29/2018

The 2nd Quarter DUR Board Meeting date has been changed to May 8th, 2018 from May 15th, 2018

03/01/2018

Updated information regarding April 1st changes posted.

11/17/2018

November 17th, 2017 DUR Board Final meeting minutes posted.

02/07/2018

February 6th, 2018 DUR Board draft meeting minutes posted.

01/26/2018

February 6th, 2018 DUR Board agenda posted.

01/16/2018

January 10th, 2018 DRAFT P&T meeting minutes posted.

12/28/2017

The 340(B) FAQ was updated in the Pharmacy Billing Information section.

12/27/2017

January 10, 2018 P&T Agenda posted.

11/29/2017

Updates to P&T and DUR Board Membership posted; Information regarding January 1st PA changes posted.

11/9/2017

PDL Effective 1/1/2018 Published.

10/31/2017

The 340(B) FAQ was updated in the Pharmacy Billing Information section.

10/11/2017

October 4th, 2017 P&T meeting minutes posted.

9/1/2017

Updated information regarding October 1st changes posted.

8/11/2017

Drug manufacturers interested in presenting at the October 4th P&T Committee meeting must submit a request to present no later than September 8th. Requests to present can be emailed to PBA_OHMedicaidFFS@changehealthcare.com.

6/2/2017

Information regarding the Coordinated Services Program, and updated pharmacy claims review manual and information regarding 7/1 PDL changes were posted.

5/8/2017

Updated information regarding April 1st changes posted.

3/29/2017

Information regarding the April 1st changes posted.

12/16/2016

The results of the 2016 Professional Dispensing Fee Survey and information on the 2017 Pricing Methodology Changes have been posted.

11/10/2016

Following the P&T meeting, ODM accepted the recommendations of the committee regarding drug placement in preferred and non-preferred positions. The recommendations will be implemented January 1, 2017. The recommendations regarding clinical criteria are under review and will be discussed at a future meeting.

10/19/2016

DUR Board Meeting on November 15, 2016 has been cancelled.

9/22/2016

October 5th P&T Meeting Agenda and Draft PDL posted

8/26/2016

August 31st Stakeholder Meeting

8/17/2016

Information for Manufacturers Interested in Presenting at the October P&T Meeting

6/12/2016

Updated Payer Sheet Information-Effective date 6/12/2016 (E1) (D.0)

6/10/2016

Memorandum Outage

6/3/2016

Pharmacy Claim Processing FAQ

6/2/2016

Medicaid.gov

6/1/2016

Provider Manual (Download)

5/31/2016

Prior Authorization Forms - Effective Date 6/12/2016 (Standard Prior Authorization form) (Suboxone/Zubsolv Prior Authorization form) (Hepatitis C Direct Acting Antiviral Prior Authorization form) (Synagis Prior Authorization form)

5/26/2016

Updated Payer Sheet Information-Effective date 6/12/2016 (E1) (D.0)

5/24/2016

Pharmacy Claim Processing FAQ

4/26/2016

Ohio Medicaid Pharmacy Pilot Testing Notification

10/2/2015

The new website has launched. Welcome to Ohio PBM!


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