Pharmacy Program Information

Announcement - 5010 D.O Information

Please be advised that the Department for Medicaid Services and the Magellan Medicaid Administration will be transitioning from NCPDP Version 5.1 to NCPDP Version D.0 in the Kentucky Medicaid Pharmacy Program on January 1, 2012. For updates click here.

Announcement - Updated information

Please click on the Pharmacy Maximum Allowable Cost Program Information for updated information.

Update: Zyvox® Prior Authorization Criteria

Jan. 15, 2010

The Department for Medicaid Services has made a change in policy related to the use of Zyvox®. The department will closely follow the new recommendations from the Pharmacy and Therapeutics Advisory Committee in conjunction with infectious disease experts in the state for the appropriate utilization of Zyvox®. As a result, a drug specific prior authorization fax form has been developed.

• Zyvox Prior Authorization Request Form

• Archived Pharmacy Announcements
• Diabetic Supply FAQ's
• PA Process for the 4 Rx Limit
• 4 Rx Limit Policy (March 1, 2006)
• 4 Rx Member Letter
• Pharmacy Provider Letter - Pharmaceutical Reimbursement (Sparil 19, 2005)
  As you may already know, the Cabinet for Health and Family Services reached an agreement last February with Kentucky's pharmacists regarding the Medicaid program's pharmacy reimbursement regulation...
• 92-Day Supply (April 18, 2005)
• Dispensing and Acquisition Costs of Pharmaceuticals in the Commonwealth of Kentucky
• Federal Upper Limit (FUL) Drug List and Labeler Updates
• NCPDP 5.1:
  Companion Guides
  • Payer Sheet
• Pharmacy POS Implementation
• Important Information regarding Medicaid's Payment Cycle (April 17, 2007)
• Important information regarding Tier 3 Pharmacy Co-payment (Sept. 25, 2006)