Brand Name Required Updates:
- Adderall XR will be brand name required - effective June 1st
- Adderall XR can be billed brand name with DAW 9 effective immediately
- Butrans will be brand name required – effective immediately
- Renexa, Norvir, and Natroba will no longer require brand name - effective immediately
Prior Authorization Updates:
- Criteria:
- NEW REQUESTS for 12-week courses of hepatitis C medications will no longer require submission of a 4 week HCV RNA level with renewal prior authorization for the final fill - effective immediately
- NPH will be covered with prior authorization for pregnancy - effective immediately
- No longer requires prior authorization: effective immediately
- PCSK9s (Praluent and Repatha)
- Humulin R U-500 Kwikpen
- Zolpidem ER
Pharmacy Team Announcements:
- Vivian will retire from the State of ND on July 31st. She has been working with pharmacies in her position for 26 years. We will greatly miss working with her and the experience she brings to our team.
- A special memo from her: “I have enjoyed working with each and every one of you. Although I’m looking forward to this new and exciting chapter in my life, I will miss talking to all of you. I plan on taking some time off and spending time with my grandson before looking for a part time job. Thank you for all the years working with you and making my job enjoyable.”
- Teri and Leann are our new Medicaid Pharmacy System Specialists. We are pleased to have Teri and Leann join our team and are confident they will be knowledgeable resources for pharmacy claim inquiries.
- Teri joined our team October 2019 to help with additional call volume experienced with Medicaid Expansion and CHIP pharmacy benefits being managed by the state.
- Leann joined our team today, May 11th, to fill Vivian's position after she retires.
- You can contact the state pharmacy provider relations team at 701-328-4086, 1-800-755-2604, or medicaidpharmacy@nd.gov. These inboxes are monitored 8a to 5p Monday through Friday, except when state offices are closed.
As a reminder, Medicaid Expansion patient’s pharmacy benefits are managed by the state:
- Please contact the state pharmacy provider relations team at 701-328-4086, 1-800-755-2604, or medicaidpharmacy@nd.gov as you would for Traditional Medicaid.
System Downtime:
- The ND Medicaid pharmacy system will be brought down at 6pm on Friday, May 22nd and remain down until approximately 12pm on Saturday, May 23rd
Alexi Murphy, PharmD
Quality and Operations Manager, Pharmacy Services
701.328.4061 (office) • 701.328.1544 (fax) • 711 (TTY
600 E. Boulevard Ave – Dept 325 • Bismarck, ND 58505-0250
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