Recent Communications
2/2/2023
Claims Review Provider Manual effective January 2023 posted
1/30/2023
February 14, 2023 DUR Board Meeting Agenda posted
New MCP Pharmacy Reference Guide posted
1/20/2023
Updated Ohio Medicaid Preferred Diabetic Supply List effective 1/1/2023 posted
1/18/2023
January 11th P&T Committee Meeting Draft Minutes posted
12/30/2022
Updated Additional Therapeutic Classes with Clinical Criteria Document posted
Quantity Limits Document effective 1-1-2023 posted
New MCP Pharmacy Reference Guide posted
Ohio Medicaid Preferred Diabetic Supply List effective 1/1/2023 posted
UPDL Criteria effective 1-1-2023 posted
Unified Preferred Drug List effective 1-1-2023 posted
12/28/2022
January 11, 2023 P&T Committee Meeting Agenda posted
12/9/2022
Covered Active Pharmaceutical Ingredients and Excipients for Compounding Effective December 9th, 2022 posted
12/1/2022
New Compound Prior Authorization Form posted
New Omnipod and V-GO Prior Authorization Form posted
New Opioid Prior Authorization Form posted
New Standard Prior Authorization Form posted
New Step Therapy Exemption Form posted
New Oral Medication Assisted Treatment of Opioid Use Disorder Prior Authorization Form posted
New Synagis Prior Authorization Form posted
New Hepatitis C Direct Acting Antiviral Prior Authorization Form posted
30-Day Change Notice for Changes Effective January 1st, 2023 posted
2023 P&T Committee Meeting Schedule posted
2023 DUR Board Meeting Schedule posted
11/30/2022
2022Q4 DUR Digest posted
2022 Cost of Dispensing Survey posted
11/15/2022
November 8, 2022 DUR Board Meeting Minutes posted
10/25/2022
November 8, 2022 DUR Board Meeting Agenda posted
10/5/2022
September 28th P&T Committee Meeting Draft Minutes posted
9/30/2022
Quantity Limits Document effective 10-1-2022 posted
Updated Additional Therapeutic Classes with Clinical Criteria Document posted
New MCP Pharmacy Reference Guide posted
Unified Preferred Drug List effective 10-1-2022 posted
UPDL Criteria effective 10-1-2022 posted
9/28/2022
DUR Board By Laws posted
9/27/2022
September 20, 2022 DUR Board Meeting Minutes posted
9/6/2022
September 20, 2022 DUR Board Meeting Agenda posted
8/31/2022
30-Day Change Notice for Changes Effective October 1st, 2022 posted
2022Q3 DUR Digest posted
8/29/2022
COVID-19 Vaccine Booster Administration Fee Provider Notice Effective 8/26/22 posted
Updated Provider Manual posted
September 28, 2022 P&T Committee Meeting Agenda posted
Supplemental Information for September 28th, 2022 P&T Committee meeting posted
7/27/2022
Claims Review Provider Manual effective July 2022 posted
7/20/2022
July 13th P&T Committee Meeting Draft Minutes posted
6/30/2022
Unified Preferred Drug List effective 7-1-2022 posted
UPDL Criteria effective 7-1-2022 posted
Quantity Limits Document effective 7-1-2022 posted
New MCP Pharmacy Reference Guide posted
Updated Additional Therapeutic Classes with Clinical Criteria Document posted
Ohio Medicaid Preferred Diabetic Supply List effective 7/1/2022 posted
Covered Active Pharmaceutical Ingredients and Excipients for Compounding effective July 1st, 2022 posted
6/29/2022
July 13, 2022 P&T Committee Meeting Agenda posted
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 posted4/13/2022
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
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
6/3/2016
6/2/2016
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
4/26/2016
Ohio Medicaid Pharmacy Pilot Testing Notification
10/2/2015
The new website has launched. Welcome to Ohio PBM!
Stay up-to-date with information on the
Ohio Medicaid Program with these helpful links:
- Preferred Drug List Updates
- MAC List Updates
- P&T Committee Meetings and Notes
- DUR Board Meetings and Notes
- Testimony and Presentations
- Ohio Medicaid Twitter