Manuals

• Drug Manufacturer Manual
• Drug Utilization Review Board Handbook
• Pharmacy Provider Payer Sheets
• Pharmacy Provider Procedure Manual
• Retrospective Drug Use Criteria Handbook
• Specialty Drug Handbook
• VDP Website Handbook

Documents

• Enrollment documents
  • Pharmacy Delivery Signage
• Education documents
  • Dispensing 72-hour Emergency Prescriptions Instructions
  • Mosquito Repellent Benefit Information
  • Pharmacy Resources for Managed Care Information
  • Real-time Eligibility Verification Information
• Managed care documents
  • MCO Contact and Pharmacy Claims Billing Information
  • MCO Service Area Information
• Formulary Management documents
  • Electronic Certificate of Information User Guide
  • Drug Addition Process
  • Preferred Drug List
  • Preferred Drug List Criteria Guide (PDF)
  • Specialty drug submission spreadsheet
• Prior Authorization call center documents
  • Registration (PDF)
  • Provider Quick Reference (PDF)
• Clinical Prior Authorization documents
  • Clinical Prior Authorization criteria guides
  • Clinical Prior Authorization assistance chart
• Drug Utilization Review Board documents
  • Agendas
  • Meeting summaries
  • Meeting minutes
  • Preferred Drug List recommendations
  • Preferred Drug List decisions

Forms

• For pharmacies
  • Refer to the list of enrollment forms
  • Refer to the list of claim processing forms
  • Refer to the list of formulary management forms
    • Long-acting reversible contraception product forms
  • Refer to the list of prior authorization requests for Medicaid FFS
  • Refer to the list of prior authorization requests for CSHCN
• For manufacturers
  • Refer to the list of formulary management forms
  • Refer to the list of drug rebate agreements
  • Refer to the list of value-based agreements
  • Refer to the list of rebate administration forms

Data Files

• † Weekly file last updated May 16.
• ‡ Quarterly file last updated April 12.
• * File last updated Feb. 2022