Pharmacy Policy
The Pharmacy Policy Unit oversees pharmaceutical coverage and reimbursement policy, clinical criteria, and monitoring pharmaceutical utilization. The unit also oversees the Pharmaceutical and Therapeutics Committee and Drug Utilization Review Board and maintains the Medicaid Preferred Drug List.
Resource Information
-
340B Covered Entities/Providers Billing Instructions
[
128.8 kB
]
- Preferred Drug Program
- Early and Periodic Screening, Diagnostic and Treatment (EPSDT)
- Preferred Drug List
- Brand Name Drug Preferred List
- Prior Authorization Requirements and Forms
- Electronic Prior Authorizations
- Drug Criteria
- Summary of Drug Limitations
- Hernandez Settlement Agreement/Ombudsman Information/Pamphlet Reorder Form
- Provider Synergies – supplemental rebate process
- Current List of Drug Rebate Manufacturers
-
Opioid Edit Resource
[
157.6 kB
]
- Updated April 30, 2024
- Pharmaceutical & Therapeutic Committee (P&T)
- HIV/AIDS Diagnosis
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HIV/AIDS Diagnosis Automatic Prior Authorization Information
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144.1 kB
]
-
HIV/AIDS Diagnosis Verification Form
[
1.3 MB
]
-
HIV/AIDS Diagnosis Automatic Prior Authorization Information
[
- Drug Utilization Review Board (DUR)
- P&T and DUR Board Meeting Notices
- Provider Alerts
- State Maximum Allowed Cost (SMAC)
- SMAC Prices
- SMAC Pricing Request Form
- Hemophilia Program
- Fee Schedules
- Behavioral Health Medication Management Resources
- Florida Medicaid Prescribed Drug Services Reimbursement Handbooks
- Additional Information
- D.0. Payer Specifications - Effective January 1, 2012. Updated July 20, 2021.
- 100 Day Supply Maintenance Medications
- Drug Efficacy Study Implementation (DESI) 5 List
- Counterfeit-proof Prescription Blank Program
- Reports and Presentations
