We have recently updated our prior authorization list and coverage policies. These changes are effective for dates of service on or after September 15, 2024.
Summary of changes
Change: Removed from formulary
- Forteo 600mg/2.4ml pen injector; consider generic
- Minocycline tablets; consider minocycline capsules
- Suprep bowel prep kit; consider generic
- Votrient 200mg tablet; consider generic
In addition to the above changes, we have updated the formulary to include a number of new medications that have been released in the past year. For a complete formulary listing, please visit our Find a drug: Medicaid page.
If you have questions regarding these changes, please contact your PacificSource Provider Service Representative or the PacificSource Pharmacy Services Team at 888-437-7728. TTY: 711. We accept all relay calls.