The Pharmacy Provider Procedure Manual defines policies and procedures for Medicaid-enrolled pharmacy providers regarding outpatient pharmacy claims, including drug benefit guidance, pharmacy prior authorization, coordination of benefits, and drug pricing and reimbursement.
| Chapter | Revised |
|---|---|
| Introduction (PDF) | May 2020 |
| Contact Information (PDF) | May 2020 |
| Enrollment (PDF) | May 2020 |
| Managed Care (PDF) | June 2019 |
| System Requirements (PDF) | May 2020 |
| Eligibility (PDF) | May 2018 |
| Coordination of Benefits (PDF) | May 2018 |
| Drug Policy (PDF) | Aug. 2020 |
| Home Health Supplies (PDF) | July 2020 |
| Vitamins and Minerals (PDF) | July 2020 |
| Mosquito Repellent (PDF) | Feb. 2020 |
| Drug Utilization Review (PDF) | May 2018 |
| Prior Authorization (PDF) | May 2018 |
| Pricing and Reimbursement (PDF) | Aug. 2020 |
| 340B Resources (PDF) | Aug. 2019 |
| Payment (PDF) | May 2020 |
| Audits (PDF) | June 2019 |
| Drug Rebates (PDF) | June 2019 |
| Forms (PDF) | May 2020 |