Apple Health (Medicaid): Provider Alert
Dear Provider,
**This notice corrects a discrepancy and removes Norflex® from Drug Class - Skeletal Muscle Relaxants.
Effective for claims with dates of service on and after June 1, 2017, the Health Care Authority (agency) will make the following changes to the Apple Health (Medicaid): Fee-for- Service Preferred Drug List (PDL):
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Drug Class
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Drug Name
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Change
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Diabetes Drugs -- SGLT-2 Inhibitors
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Synjardy XR®
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Added as Non-Preferred, not subject to TIP/DAW-1 override.
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|
Multiple Sclerosis
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Ocrevus®
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Added as Non-Preferred, subject to DAW-1 override.
|
|
NSAIDs
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Entire class
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Client must try all preferred drugs before a non-preferred drug will be authorized unless contraindicated or not clinically appropriate.
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Skeletal Muscle Relaxants
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Entire class
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Client must try all preferred drugs before a non-preferred drug will be authorized unless contraindicated or not clinically appropriate.
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Skeletal Muscle Relaxants
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cyclobenzaprine 5mg
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Preferred
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Skeletal Muscle Relaxants
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cyclobenzaprine 7.5mg
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PA required.
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Skeletal Muscle Relaxants
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cyclobenzaprine 10mg
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Preferred
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Skeletal Muscle Relaxants
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Norflex®
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Removed, no longer manufactured.
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For more details, see the agency’s Apple Health Medicaid: Fee-for-Service Preferred Drug List.
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