Nebraska Medicaid program

March 2024

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through March 1, 2024. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

February 2024

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through February 1, 2024. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

January 2024

November 2023 P&T Changes within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Friday, January 19, 2024. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through January 19, 2024. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through January 2, 2024. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

December 2023

November 2023 P&T Changes within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Friday, January 19, 2024. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through December 1, 2023. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

November 2023

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through November 3, 2023. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

October 2023

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through October 1, 2023. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

September 2023

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through September 1, 2023. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

August 2023

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through August 1, 2023. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

July 2023

May 2022 P&T Changes within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Friday, July 21, 2023. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through July 21, 2023. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

July 2023

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through July 1, 2023. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

June 2023

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through June 1, 2023. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

May 2023 P&T Changes Within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Friday, July 21, 2023. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

May 2023

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through May 1, 2023. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

April 2023

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through April 1, 2023. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

March 2023

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through March 1, 2023. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

February 2023

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through February 1, 2023. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

January 2023

November 2022 P&T Changes Within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Friday, January 20, 2023. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through January 1, 2023. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

December 2022

November 2022 P&T Changes Within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Friday, January 20, 2023. The updated lists can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

December 2022

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through December 1, 2022. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

November 2022

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through November 1, 2022. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

October 2022

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through October 1, 2022. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

September 2022

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through September 1, 2022. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

August 2022

Pertinent Changes to Provider Web Portal

Effective 8/30/2022, Magellan is implementing pertinent changes to our web portals and web-based applications and tools. We will implement OKTA with multifactor authentication for our provider web-based applications accessed via the web portal. Current users of Web Claims Submission (WCS) will need to complete a short migration process to verify their access credentials and move all existing application permissions to the new OKTA platform. Please review the migration step-by-step job aid. If a new pharmacy provider would like to register for WCS, they can still do so by clicking the UAC link to access our User Administration Console (UAC).

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through August 1, 2022. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

July 2022

May 2022 P&T Changes Within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Friday, July 22, 2022. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through July 22, 2022. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

June 2022

May 2022 P&T Changes Within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Friday, July 22, 2022. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

Upcoming Pertinent Changes to Provider Web Portal

Magellan is implementing pertinent changes to our web portals and web-based applications and tools. We will implement Okta with multifactor authentication for our provider web-based applications accessed via the web portal. Current users of Web Claims Submission (WCS) will need to complete a short migration process to verify their access credentials and move all existing application permissions to the new Okta platform. A migration step-by-step job aid will be posted to the web portal prior to implementation. If a new pharmacy provider would like to register for WCS, they can still do so by clicking the UAC link to access our User Administration Console (UAC).

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through June 1, 2022. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

May 2022

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through May 2, 2022. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

April 2022

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through April 1, 2022. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

March 2022

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through March 1, 2022. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

February 2022

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through February 1, 2022. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

January 2022

November 2021 P&T Changes Within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Friday, January 21, 2022. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through January 21, 2022. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through January 3, 2022. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

December 2021

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through December 1, 2021. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

November 2021

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through November 1, 2021. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

October 2021

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through October 1, 2021. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

September 2021

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through September 2, 2021. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

August 2021

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through August 2, 2021. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

July 2021

May 2021 P&T Changes Within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Thursday, July 15, 2021. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through July 15, 2021. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

June 2021

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through June 1, 2021. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

May 2021

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through May 1, 2021. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

April 2021

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through April 1, 2021. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

March 2021

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through March 1, 2021. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

February 2021

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through February 2, 2021 and February 1, 2021, respectively. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

January 2021

November 2020 P&T Changes Within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Thursday, January 21, 2021. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through January 21, 2021. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

December 2020

November 2020 P&T Changes Within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Thursday, January 21, 2021. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through December 1, 2020. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

November 2020

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through November 3, 2020. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

October 2020

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through October 1, 2020. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

September 2020

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through September 1, 2020. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

August 2020

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through August 1, 2020. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

July 2020

May 2020 P&T Changes Within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Thursday, July 16, 2020. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through July 1, 2020. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

June 2020

May 2020 P&T Changes Within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Thursday, July 16, 2020. The updated list can be found at: https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through June 1, 2020. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

May 2020

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through May 1, 2020. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

April 2020

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through April 1, 2020. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

March 2020

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through March 1, 2020. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

February 2020

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through February 1, 2020. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

January 2020

November 2019 P&T Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Thursday, January 16, 2020. The updated list can be found at: https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through January 16, 2020. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

December 2019

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through December 1, 2019. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

November 2019 P&T Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Thursday, January 16, 2019. The updated list can be found at: https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

November 2019

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through November 1, 2019. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

October 2019

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through October 1, 2019. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

September 2019

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through September 1, 2019. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

August 2019

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through August 1, 2019. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

July 2019

May 2019 P&T Changes within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Thursday, July 18, 2019. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through July 1, 2019. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

June 2019

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through June 1, 2019. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

May 2019 P&T Changes within the Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Thursday, July 18, 2019. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

May 2019

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through May 1, 2019. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

April 2019

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through April 1, 2019. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

March 2019

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through March 1, 2019. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

February 2019

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through February 1, 2019. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

January 2019

November 2018 P&T Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Thursday, January 17, 2019. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through January 1, 2019. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

December 2018

November 2018 P&T Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available. The changes are highlighted in red and will go into effect on Thursday, January 17, 2019. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through December 1, 2018. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

November 2018

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through November 1, 2018. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

October 2018

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through October 1, 2018. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

September 2018

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through September 1, 2018. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

August 2018

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through August 1, 2018. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

July 2018

May 2018 P&T Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available and will go into effect on Thursday, July 19, 2018. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through July 1, 2018. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

June 2018

May 2018 P&T Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available and will go into effect on Thursday, July 19, 2018. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through June 1, 2018. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

May 2018

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through May 1, 2018. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

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

April 2018

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through April 1, 2018. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

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

March 2018

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through March 1, 2018. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

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

January 2018

November 2017 P&T Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available and will go into effect on Thursday, January 25, 2018. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through January 1, 2018. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

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

December 2017

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through December 1, 2017. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

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

November 2017

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through November 1, 2017. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

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

October 2017

November P&T Agenda Posted

The next Pharmacy & Therapeutics (P&T) Committee Meeting is scheduled for November 8, 2017, to be held at the Eugene Mahoney State Park, Peter Kiewit Lodge, 28500 West Park Hwy, Ashland, NE 68003.

The agenda can now be viewed at: https://nebraska.fhsc.com/PDL/PTcommittee.asp

Preferred Drug List (PDL) Changes Coming in November 2017

Hepatitis C Treatments: As of November 1, 2017, Mavyret (glecaprevir/pibrentasvir) will be a preferred agent. Class Criteria and/or a Prior Authorization form may still be required.

Opiate Dependence Treatments: As of November 6, 2017, prior authorization will NOT be required for preferred products.

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through October 1, 2017. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

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

September 2017

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through September 1, 2017. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

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

July 2017

May 2017 P&T Preferred Drug List (PDL) Now Available

The Preferred Drug List (PDL) decided by the Nebraska Pharmaceutics & Therapeutics (P&T) Committee and approved by the NE DHHS, is now available and will go into effect on Thursday, July 20, 2017. The updated list can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through July 1, 2017. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

Providers of Fee-for-Service (FFS) members 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

June 2017

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through June 1, 2017. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

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

April 2017

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through April 1, 2017. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

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

March 2017

Preferred Drug List (PDL)/Claim Limitations Document Updates

The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through March 1, 2017. The updated lists can be found at:
https://nebraska.fhsc.com/downloads/NEClaimLimitations.pdf
https://nebraska.fhsc.com/PDL/PDLlistings.asp

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

January 2017

Claim Limitations Document Update

The Claim Limitations Document has been updated with changes through January 1, 2017. The updated list can be found at: https://nebraska.fhsc.com/downloads/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

December 2016

Preferred Drug List (PDL) Update: P&T Implementation

On November 2, 2016 the Pharmaceutics and Therapeutics (P&T) board met and agreed upon changes to the PDL. The implementation date for these changes is Thursday, January 19, 2017. Updated Clinical Exception Criteria, if any, will be found on the Preferred Drug List (PDL) document found at: https://nebraska.fhsc.com/PDL/PDLlistings.asp after December 15, 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

Clinical Criteria Update: Hepatitis C

As a result of the September 2016, Drug Utilization Review (DUR) Board Meeting, and changes in current therapy options, NE DHHS has incorporated changes to the Clinical Criteria and Fax Forms for Hepatitis C approval. Links to any and all Clinical Criteria or Fax forms can be found on the Preferred Drug List (PDL) document found at: https://nebraska.fhsc.com/PDL/PDLlistings.asp.

They may also be found at the links below:

Clinical Criteria Forms: https://nebraska.fhsc.com/priorauth/clinicalcriteria.asp

PA Fax Forms: https://nebraska.fhsc.com/priorauth/paforms.asp

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

October 2016

November 2016 P&T Agenda Posted

The agenda for the November 2, 2016 P&T meeting has been posted. All information for the upcoming and past P&T meetings can be found at https://nebraska.fhsc.com/PDL/PTcommittee.asp.

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/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

October 2014

Olanzapine (Zyprexa®) Single Daily Dose

On November 3, 2014 olanzapine (Zyprexa®) will be covered by Nebraska Medicaid, following the FDA-approved guidelines of once-a-day dosing schedule. Consolidating a patient's multiple daily dosage of olanzapine (Zyprexa®) to once daily administration will decrease the pill burden and possibly increase patient compliance. Prescribing a single dose of a higher strength of olanzapine (Zyprexa®) to deliver the same total daily dose is a more cost-effective use of State resources as well. 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

September 2014

Abilify® (aripiprazole) Single Daily Dosing

On October 1, 2014, Abilify® (aripiprazole) will be covered by Nebraska Medicaid, following the FDA-approved guidelines of one daily dose of 2 mg, 5 mg, 10 mg, 15 mg, 20 mg, or 30 mg tablets. Consolidating a patient's multiple daily dosage of Abilify® (aripiprazole) to once daily administration will decrease the pill burden and possibly increase patient compliance. Prescribing a single dose of a higher strength of Abilify® (aripiprazole) to deliver the same total daily dose is a more cost-effective use of State resources as well. Providers may contact Magellan Medicaid Administration at 800-241-8335 to document patient specific clinical considerations requiring exception to these limits.

Preferred Drug List (PDL) Changes:

December 2013

FDA Revised Zolpidem Dosing Guidelines: Limits To Be Implemented for Zolpidem Immediate-Release Products

The FDA revised the dosing guidelines for zolpidem. The new guidelines can be accessed at www.fda.gov/safety/medwatch/safetyinformation/safetyalertsforhumanmedicalproducts/ucm334738.htm. The recommended initial dose of immediate-release zolpidem products is 5 mg for females and either 5 mg or 10 mg for males. Limits will be put in place on January 23, 2014 to deny claims for females for the 10mg immediate-release dosage strength and quantity limits of one tablet per day will be implemented for both dosage strengths of zolpidem immediate-release products for both males and females.

July 2013

Preferred Drug List (PDL) Update: Brand Lovenox® and Enoxaparin Statuses

The statuses of generic ENOXAPARIN and brand Lovenox® announced in March 2013 must be changed. Brand Lovenox® has been changed back to preferred on the PDL and no longer requires prior authorization. Generic ENOXAPARIN will retain preferred status until August 26, 2013, when it will again become non-preferred.

March 2013

Preferred Drug List (PDL) Update

The status of generic ENOXAPARIN has been changed to preferred on the PDL, and no longer requires prior authorization. Brand name Lovenox® will retain preferred status until May 29, 2013, when it will become non-preferred.

January 2013

SMAC pricing

Effective January 22, 2013, the Department of Health and Human Services, Division of Medicaid & Long-Term Care (MLTC) will begin contracting with Magellan Medicaid Administration (MMA) for SMAC pricing. MMA will provide assistance in establishing and maintaining the SMAC rates for medications covered in the pharmacy program. As new SMAC rates are developed, the rates will be posted on the nebraska.fhsc.com website. Please visit this website regularly for changes to the SMAC list.
Providers may submit a MAC Price Research Request Form if there are concerns with current rates established. This form can also be obtained online at nebraska.fhsc.com and can be submitted via email to StateMACProgram@magellanhealth.com or faxed to 888-656-1951. A copy of the purchasing invoice for the medication must accompany the MAC Price Research Request form in order to evaluate a MAC price inquiry

December 2012

Medicare Improvement for Patients and Providers Act of 2008 (MIPPA)

Nebraska Medicaid currently provides coverage of generic benzodiazepines and barbiturates for all Medicaid eligible clients. Beginning January 1, 2013 Nebraska Medicaid will no longer cover these two classes of medications for Medicare eligible clients. Coverage for these medication classes will become the responsibility of the client's Medicare Part D plan as required under MIPPA. Pharmacies will need to update their system to ensure claims for these medications are billed to the correct processor.

Please email questions to dhhs.MedicaidPharmacyunit@nebraska.gov.

August 2012

Medication Prior Authorization (PA) Forms

Currently, there are specific prior authorization (PA) forms for Proton Pump Inhibitors (PPIs), NSAIDs: CoxI, Single Entity or Combination Brand Name, and Low/Non-Sedating Antihistamines (LSAs) located at separate links on the website (nebraska.fhsc.com) on the tab, Prior Authorization, and the drop down for PA Forms. Beginning August 27, 2012, these drug class specific PA forms will be replaced by the Documentation of Medical Necessity form which currently exists at its own link under PA forms. When going to the link for these drug class specific forms, the Documentation of Medical Necessity form will be provided and should be used to request prior authorization. Additionally, the PDL Exception Request form will also be replaced by the Documentation of Medical Necessity form and will be provided at the link on the same website on the tab, Preferred Drug List, and the drop down for PDL Exception Request.

Standard Dispensing Fee

Currently the State has thirteen different dispensing fees across participating Medicaid providers. Standardization to one dispensing fee is being implemented in order to be equitable to all providers. Analysis was done where all dispensing fees were compared. A dispensing fee of $4.45 reflects the average fee paid. Effective September 4, 2012 the dispensing fee of $4.45 will be paid to all participating providers.

March 2012

Universal Claim Form

With the implementation of NCPDP version D.0 for pharmacy claims submission, there is a new version of the Universal Claim Form (UCF). This new version 1.1 has an expanded number of fields, some of which were not present on the previous version but are now required. Providers are encouraged to begin using the new form as soon as possible. Claims received after April 15, 2012 will be required to utilize the new form. The NCPDP Universal Claim Forms may be purchased from NCPDP vendor, CommuniForm. The forms can be ordered online at www.Communiform.com/NCPDP or (800) 869-6508.

December 2011

D.0 and Prescriber NPI

Beginning 01/01/2012, Nebraska Medicaid will only accept claims submitted in the NCPDP D.0 format. Due to unforeseen circumstances there will not be a dual-format period where claims can be submitted in either the current 5.1 format or the new D.0 format. Any claim submitted in the current 5.1 format on or after 01/01/2012 will deny and need to be re-submitted in the D.0 format to be considered for payment.

As a reminder Governmental COB requires full disclosure of all amounts paid and patient responsibility. Medicaid is the payer of last resort and, as such, is obligated to determine the Medicaid allowed amount without regard to the allowed amount of any upstream payer. DHHS allowed Other Payer Amounts Paid from upstream processors is deducted from the Medicaid Allowed Amount to determine the final DHHS financial responsibility for the claim. In the event upstream payers impose a co-pay or coinsurance amount this value is also used to determine DHHS' fiscal responsibility.

As a condition of participation, providers participating in Nebraska Medicaid agree to accept as payment in full the amount paid according to the Department's payment methodologies after all other sources have been exhausted. In the event final calculated amounts demonstrate that DHHS' fiscal responsibility has been met or that the DHHS fiscal responsibility is below the submitted Other Payer Patient Responsibility the amount returned as DHHS Amount Paid is considered payment in full and any amount submitted in the Other Payer Patient Responsibility above the amount paid by the Department is not to be collected from the patient/client.

Prescriber NPI will be required on all claims as of January 1, 2012. Until then, claims may continue to be submitted with the state license number. On 01/01/2012 or after if you have submitted a claim using the prescriber's NPI and are receiving a message stating missing or invalid prescriber ID (NCPDP reject code 56), the NPI submitted is not yet on our files. During regular business hours, please have the prescriber contact the Nebraska Provider Enrollment area at 877-255-3092. All other times please contact the Pharmacy Help Desk at 800-368-9695.

Urgent Notice: D.0 Pharmacy Claims

Due to unforeseen circumstances, Nebraska Medicaid will not be accepting pharmacy claims in D.0 format beginning on December 14, 2011 as previously communicated. An announcement will be forthcoming as to the new implementation date.

September 2011

Notice: Upcoming system maintenance

On Saturday, September 17, 2011, Magellan Medicaid Administration will be performing network maintenance from 10 PM (CT) until the morning of Sunday, September 18th at approximately 8 AM (CT). During that time, the normal POS pharmacy claims processing system will be out of service.

May 2011

Attn Pharmacy: Cough and Cold Changes

This week several cough and cold products were removed from coverage by Nebraska Medicaid. The changes were made in response to notification that the products had never received FDA approval and were therefore not coverable. The attached Covered Products List has been updated to remove the items that are no longer covered. Coverage information for specific NDCs can be found via the Drug LookUp at https://nebraska.fhsc.com. If you require further assistance with finding covered products please call DHHS at 877-255-3092.

March 2011

Notice: Upcoming system maintenance

On Saturday, March 26, 2011, Magellan Medicaid Administration will be performing network maintenance from 4 PM (CT) until approximately 10 PM (CT). During that time, WebPA, Web Claims Submission and the Drug Lookup on the nebraska.fhsc.com website will be out of service. This maintenance does not affect claims processed via the normal POS claims processing system.

January 2011

Compounded Prescriptions with APIs and Excipients

An API is a bulk drug substance, which is defined by the FDA as any substance that is represented for use as a drug and that, when used in the manufacturing, processing or packaging of a drug, becomes an active ingredient of the drug product. APIs may be included in extemporaneously compounded prescriptions and may serve as the active drug component in a compounded formulation.

State Medicaid programs have been informed by the Centers for Medicare & Medicaid Services (CMS) that many active pharmaceutical ingredients (APIs) and excipients used in compounding do not meet the definition of a covered outpatient drug as defined in section 1927(k)(2) of the Social Security Act and effective January 1, 2011, are not eligible for coverage as drugs in Medicaid programs. Therefore, Nebraska Medicaid will no longer cover such products for dates of service on and after January 1, 2011.

Lists of APIs and excipients identified in the Medicaid Drug Rebate system are posted on the CMS website at http://www.cms.gov/Reimbursement/02_Spotlight.asp. Please note that these are not definitive lists and additional products will be added as they are identified.

If you are treating a recipient who is currently receiving a prescription containing one of the APIs or excipients to be deleted, you must identify an alternative therapy that meets the definition of a covered outpatient drug and is eligible under the federal drug rebate program. Information regarding products covered by NE Medicaid can be found on the Drug Lookup posted at https://nebraska.fhsc.com.

If you have any questions regarding this bulletin please contact Barbara Mart, R.P., Pharmacy Consultant, at (402) 471-9301 or barbara.mart@nebraska.gov.

August 2010

Upper Limit on Compounded Prescriptions

Nebraska Medicaid is implementing an upper limit on compounded prescriptions. Beginning August 26,2010 claims designated as compounds with a calculated reimbursement over $140.00 will require authorization by DHHS. Compounded PPI and sildenafil suspensions for children are exempted. Before calling for an override please verify the claim you are submitting is a valid compound claim and that you are using the most cost-effective ingredients. Please call DHHS at 877-255-3092 if you determine an override is required.

June 2010

ATTENTION PHARMACY PROVIDERS

Nebraska Medicaid is implementing an upper limit on Over-The-Counter (OTC) claims. Beginning June 2, 2010 OTC claims with a calculated payment over $40.00 will require authorization. BEFORE calling for an override please review that you are dispensing the most cost-effective product or reduce the quantity to be dispensed. For situations that cannot be resolved with the above changes please call DHHS at 877-255-3092. Be sure to have documentation to support the medical necessity of the product, quantity and dose when calling.

January 2010

Inclement Weather Notice

In case of inclement weather, the February 10, 2010 and the March 10, 2010 meetings of the Nebraska Medicaid Pharmaceutical and Therapeutics Committee will be cancelled IF Lincoln Public Schools or Omaha Public Schools are cancelled due to weather.

November 2009

Important Notice to Nebraska Medicaid Providers

This announcement is specifically for those providers who submit pharmacy claims via the web and not through the point-of-sale claims processing system.

Due to system maintenance, the Web Claims Submission application will be unavailable for approximately 30 minutes between Sunday, November 22, 11pm ET and Monday, November 23, 6am ET.

The downtime will occur sometime between the hours of 10 PM CT and 6 AM CT Monday morning, November 23rd. We apologize for this interruption in service.

October 2009

Important Notice to Nebraska Medicaid Providers

The Drug Lookup feature on this website had been updated to include the following changes:

• Coverable Bulk chemicals are now designated as "Covered"
• Coverable Vehicles are now designated as "Covered"

Reminder: Bulk Chemicals and vehicles are only covered on Medicaid claims when submitted as part of a multi-ingredient compound.

September 2009

Nebraska Medicaid Pharmaceutical and Therapeutics (P & T) Committee

The first meeting of the Nebraska Medicaid Pharmaceutical and Therapeutics Committee was held August 26, 2009. Decisions from that meeting will be implemented in October 2009. The PDL, inclusive of the therapeutic classes reviewed at the August Meeting, is posted on this website, under the PDL tab. Claims for non-preferred medications will begin to deny on October 14, 2009.

July 2009

Nebraska Medicaid Pharmaceutical and Therapeutics (P & T) Committee

On August 26, 2009, the Nebraska Medicaid P & T Committee will hold its first meeting to make recommendations to the State for preferred drugs in eighteen drug classes to be included on the Preferred Drug List (PDL). Another seventeen drug classes will be reviewed for preferred drug recommendations in a second meeting scheduled for September 24, 2009. For additional details, please see the Agendas for these meetings posted under Preferred Drug List tab and P & T Committee. Registration (sign-in) for all attendees begins at 8 a.m. for both meetings.

May 2009

Coverage Reinstated On Polyethylene Glycol 3350 Products

Nebraska Medicaid recently notified you of a change by CMS removing coverage of PEG3350 products effective 04/27/2009. Further instruction was received this week from CMS as follows.

After further review, however, we have determined that no action should be taken with respect to these NDCs at this time. As a result, the NDCs remain eligible for coverage under the Medicaid Drug Rebate Program and should be changed in your Medicaid Drug Rebate system to reflect a DESI code of 2 as of the date of this email.

We apologize for any inconvenience that this may cause.

First Health is updating the claim system 05/27/2009 to allow payment of PEG3350 products.

April 2009

Coverage Change on Polyethylene Glycol 3350 Products

Nebraska Medicaid has received notice that the FDA has determined that Polyethylene Glycol 3350 products were incorrectly reported by manufacturers with DESI code of 2. The products will now be listed with a DESI 5 (i.e., less than effective status for all indications). CMS notified states in a notice dated 04/23/2009 that these products are no longer eligible for coverage under the Medicaid program effective immediately. This includes Miralax, Glycolax and all other prescription or OTC PEG 3350 products. First Health has been instructed to update the claims system to reject as "drug not covered" any claim for PEG 3350 with a date of service 04/27/2009 or later. Because this change is a program mandate from CMS, DHHS cannot authorize overrides. Nebraska Medicaid will continue to cover FDA approved and rebate eligible products per the program rules for the Medicaid population.

March 2009

Oxycontin

ATTN PHARMACY: Nebraska Medicaid will be implementing changes to Oxycontin® coverage effective 04/01/2009. Prior authorization will be required for dosing that exceeds three (3) tablets daily of 10mg, 15mg, 20mg, 30mg, 40mg and 60mg. Notice was sent to physicians identifying clients who had prescriptions in the last month that would require authorization with the change. The notice is asking to consider dose consolidation to the higher strength for regimens that require taking the medication more than twice per day or more than 3 tablets per day. For example, if the patient is taking six 10mg tablets daily please consider use of either 20mg three times daily or 30mg twice daily. For patients that require alternate dosing the Documentation of Medical Necessity for High Dose Override form must be completed by the prescriber. Forms are available on the First Health web site at: http://nebraska.fhsc.com/. If you have any questions please contact the pharmacy program at 877-255-3092.

January 2009

Metoprolol ER Tablets

On December 3, the FDA announced a recall of millions of bottles of metoprolol ER manufactured by Sandoz. Toward the end of December, Ethex voluntarily stopped shipping several products, including metoprolol XL. That only left two suppliers in the market AstraZeneca (the brand Toprol XL) and the authorized generic by Par. Par is not keeping up with the demand in the market for generic metoprolol ER. On January 10, 2009, Par took a price increase on 25mg, 50mg, 100mg, and 200mg tablets in excess of 17% over previous market prices.

Due to the above announcement, SMAC on all strengths of Toprol XL is temporarily being adjusted with eff start date of 01/01/09 to allow for dispensing of brand if the pharmacy is unable to obtain generic during the shortage. Hopefully, this will eliminate the need for MC6s.

December 2008

Important Notice to Nebraska Medicaid Providers

Nebraska Medicaid offices will be closed for the Christmas holiday on Thursday and Friday, December 25th and 26th and reopen on Monday, December 29th. In addition, the offices will be closed on Thursday, January 1st, 2009 in observance of New Year's Day.

For any circumstances that require immediate attention during these holidays, you may contact First Health Services by using the following phone numbers:

Technical Call Center (Pharmacy Help Desk) 800-368-9695
Clinical Call Center (Prior Authorizations) 800-241-8335

November 2008

Change in coverage of Proton Pump Inhibitors

Prilosec OTC tablets will no longer be available without prior authorization through Nebraska Medicaid beginning on December 15, 2008. Prior authorization requirements have been removed from omeprazole 20mg capsules. Please begin converting your clients from Prilosec OTC to omeprazole capsules immediately. In order for pharmacies to accomplish this conversion Prilosec OTC will remain covered until December 15, 2008, when claims will then deny for Prior Authorization required. Patients with Medicare coverage will need to be converted to the preferred agent of their Medicare Part D plan. If you would like a report detailing your patients who have received a Prilosec OTC claim from your pharmacy in the past 30 days please contact the pharmacy program at 877-255-3092 with your pharmacy NPI number and fax number. This change is for omeprazole 20mg capsules only, omeprazole 10mg and 40mg capsules will remain on Prior Authorization.

September 2008

Important Notice to Nebraska Medicaid Providers

Pharmacies are reminded that beginning October 1, 2008, regardless of date of service, all claims for new prescriptions submitted to Nebraska Medicaid must contain the Prescription Origin Code (NCPDP Field #419-DJ). Valid values include:

• 0 = Transfer
• 1 = Written
• 2 = Telephone
• 3 = Electronic
• 4 = Facsimile

Please note that 0 should be used on transfer prescriptions only. Pharmacies submitting incorrect information may be sanctioned. Failure to submit the field or submission of invalid values will cause claims to reject. For more information, see Provider Bulletin #08-33.

August 2008

Attention! To all Nebraska Medicaid Prescribers and Pharmacy Providers:

We regret to inform you that the system for registering to be able submit Web Prior Authorizations and Web Pharmacy Claims will be out of service until Sunday, August 31, 2008 at approximately 7:00 AM EDT. This only affects the registration part of the process and does not affect the actual login and submission of Prior Authorizations or Pharmacy Claims. We apologize for this downtime and any inconvenience that you may have incurred.

July 2008

Important Notice to Nebraska Medicaid Providers

FHSC/CVTY on behalf of Nebraska Medicaid offers access to the Nebraska Web PA application for the submission of Prior Authorization requests for Pharmaceuticals and access to the Nebraska Web Claims Submission application for submission of Pharmacy Claims.

• If you are a physician/prescriber seeking access to WebPA you can request a PIN for registration by using your State License Number only. Click here for a complete Prescriber License Number Listing.
• If you are a pharmacy seeking access to Web Claims submission and/or Nebraska Web PA, you can request a PIN for registration by using your National Provider Identification (NPI) number only.
• If you are a dispensing practitioner seeking access to Web Claims submission you can request a PIN for registration by using your Pharmacy National Provider Identification (NPI) number only.

If you need further assistance with PIN registration, please call the Web Support Call Center at 1-800-241-8726.

June 2008

***IMPORTANT CHANGE***

Please note the following change to the previously communicated 9:00 pm CT (8:00 pm MT) ACS shut off time on June 10, 2008. The new ACS shut off time is 7:00 pm CT (6:00 pm MT). Providers should hold claims from this time until First Health Services begins processing claims at 8:00 am CT (7:00 MT) on June 11, 2008. We apologize for any inconvenience and appreciate your cooperation

Voluntary Participation for Testing Point of Purchase (POP) and Web Claim Submission Claims

To those of you wishing to voluntarily participate in the testing of functionality, the FHSC Vendor Certification Group will be able to assist you with the scheduling of this testing effort. For your reference, the open testing period for this voluntary effort is listed below:

• Point of Purchase (POP) testing activities will be available weekdays from May 19th - June 6th from 10 am - 2 pm CT.
• Web Claim Submission testing activities will be available weekdays from June 2nd - 30th from 10 am - 2 pm CT.

To coordinate this activity, please contact the Vendor Certification group by calling 804-217-7900.