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 |