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What is the coverage status for new medications?

April 26, 2017coverage medications Status

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What is the coverage status for new medications?

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If a new drug is in a class that is subject to the PDL, then it is considered PDL neutral (refer to question #18) and the drug is covered by the program and does not require prior authorization. If a new drug is in a class that is not subject to the PDL, and is not included in the list of non-covered legend drugs at 405 IAC 5-24-3, the drug is covered by the program and does not require prior authorization.