Managed Care

Pharmacy providers must enroll with Medicaid before participating in managed care pharmacy networks.

• Contact the managed care organizations
• Managed care complaint process
• List of required and optional clinical prior authorizations
• Review the Clinical Prior Authorization Assistance Chart for prior authorizations used by each MCO
• MCO Resources

Resources for managed care organizations:

• Managed Care Resources Update Request (HHS Form 1344)
• MCO Quarterly Clinical Prior Authorization Reporting Crosswalk (Excel)
• Managed Care Contracts and Manuals