Apple Health (Medicaid): Metformin SR Policy Change
Washington State Health Care Authority sent this bulletin at 04/06/2017 02:21 PM PDT
Apple Health (Medicaid): Provider Alert
Dear Provider,
Effective
for dates of service on or after May 1, 2017, Washington
Apple Health (Medicaid) will require prior
authorization for Fortamet® (metformin SR 24HR osmotic), Glumetza® (metformin SR
24HR modified release), and their generic equivalents for the Fee-for-Service
(FFS) Prescription Drug Program.
A less costly, covered alternative that does not require prior
authorization is generic Glucophage XR® (metformin SR 24HR).
To request prior authorization, please complete and submit
the Pharmacy Information Authorization (HCA 13-835A) form and fax to
1-866-668-1214 or call Pharmacy Authorization at 1-800-562-3022. Forms can be found on the agency’s Forms
& publications web page.
Please do
not reply directly to this message. If you have feedback
or questions, please visit the HCA
website for contact information.
About
WashingtonStateHealth Care Authority HCA oversees the state’s top
two health care purchasers — Washington Apple Health (Medicaid) and the Public
Employee Benefits Board Program. We work with partners to help ensure
Washingtonians have access to better health and better care at a lower cost. For
more information, visit www.hca.wa.gov.