Movement of Physician Administered Drugs to the Pharmacy Benefit Postponed

Date: 04/09/19

Managed Health Services (MHS) previously communicated a new program that would move select infusion medications from the physician administered drug medical benefit to the pharmacy benefit effective 4/1/2019.  We have postponed this initiative and will not implement the change at this time.  

All previous authorization requests will be reactivated in our claim system.  We do not require that you resend the PA request in the event you have a previous approval letter. Reactivation of the PA will allow claims to continue to pay through the medical benefit and we do not anticipate claim denials related to this change.

New authorization requests should follow the established PA process including using the IHCP Authorization form or submission of PA to MHS through our provider web portal. Thank you for being our partner in care.