Nebraska Medicaid program

Welcome to the website for the Nebraska Medicaid Pharmacy Program - Point of Sale System (POS). The Nebraska Department of Health and Human Services, Medicaid and Long Term Care division has contracted with Magellan Medicaid Administration, Inc. as the Nebraska Pharmacy Benefits Administrator.

Nebraska Medicaid provides for health care services to eligible elderly and disabled individuals and eligible low-income pregnant women, children and parents. Medicaid provides health care for more than one in every ten Nebraskans.

Magellan Medicaid Administration, Inc. is responsible for:

• Operations Support of the Point of Sale System
• Call Center Operations for Providers
• Clinical Consultation Services
• Education and outreach activities for Providers

September 2016

Preferred Drug List (PDL) Update: Methadone Status

On October 3, 2016 methadone (Dolophine®/Methadose®/Methadone Intensol®) will be transitioned to non-preferred status as decided as a result of the May 2016 P&T changes and previously announced. All forms and strengths of methadone will require prior authorization. Clinical Exception Criteria will be found on the Preferred Drug List (PDL) document found at: nebraska.fhsc.com/downloads/PDL/NE_PDL.pdf after September 16, 2016.

Providers may contact Magellan Medicaid Administration via phone or fax to document patient specific clinical considerations requiring exception to these limits.

Magellan Medicaid Administration, Inc:

• Fax 1-866-759-4115
• Tel 1-800-241-8335

Preferred Drug List (PDL) Update: Clinical Criteria

The Preferred Drug List (PDL) has been updated to include Clinical Exception Criteria. The current PDL can be found at: nebraska.fhsc.com/downloads/PDL/NE_PDL.pdf.

Providers may contact Magellan Medicaid Administration via phone or fax to document patient specific clinical considerations requiring exception to these limits.

Magellan Medicaid Administration, Inc:

• Fax 1-866-759-4115
• Tel 1-800-241-8335

Claim Limitations Document Update

The Claim Limitations Document has been updated with changes through August 31, 2016. The updated list can be found at: nebraska.fhsc.com/downloads/PDL/NEClaimLimitations.pdf.

Providers may contact Magellan Medicaid Administration via phone or fax to document patient specific clinical considerations requiring exception to these limits.

Magellan Medicaid Administration, Inc:

• Fax 1-866-759-4115
• Tel 1-800-241-8335