Nebraska Medicaid program
Providers • Archived Web Announcements
Archived Web Announcements
October 2024
Preferred Drug List (PDL)/Claim Limitations Document Updates
The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through October 2, 2024. The updated lists can be found at:
https://nebraska.fhsc.com/PDL/PDLlistings.asp
Providers of Fee-for-Service (FFS) members may contact Prime Therapeutics State Government Solutions via phone or fax to document patient specific clinical considerations requiring exception to these limits.
Prime Therapeutics State Government Solutions:
- Fax 1-866-759-4115
- Tel 1-800-241-8335
September 2024
Preferred Drug List (PDL)/Claim Limitations Document Updates
The Preferred Drug List (PDL) and Claim Limitations Document have been updated with changes through September 3, 2024. 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
August 2024
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, 2024. 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
July 2024
May 2024 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 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 July 1, 2024. 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
June 2024
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, 2024. 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
May 2024
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, 2024. 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
April 2024
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, 2024. 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
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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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/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 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: 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 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:
Antiparasitics, Topical | Ulesfia© (Benzyl Alcohol) will become NONPREFERRED on 09/15/2014 |
Lipotropics (nonstatin) | Generics now preferred: Fenofibrate (generic for Tricor©) Fenofibric acid (generic for Trilipix©) (Brand non-preferred) |
Stimulants | Amphetamine salt combo IMMEDIATE RELEASE - Now PREFERRED Adderall ® IMMEDIATE RELEASE will become NONPREFERRED 09/15/2014 (note:Adderall XR® remains brand preferred over generic) |
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.