What steps have been taken to educate the Medicaid managed care plans about implementation of the PDL?
TMA has received several calls from physician offices confused about whether Medicaid managed care patients are subject to the PDL and prior authorization process. When the physicians contacted their local plan representatives, the representatives were unable to confirm that Medicaid managed care patients are indeed subject to the PDL. A. Dr. Hellerstedt met with the Medicaid Managed Care Medical Directors on Jan. 22 and provided some information and led a discussion on PDL. HHSC staff discussed the PDL with Medicaid managed care representatives last week, and confirmed that Medicaid managed care patients will be subject to the PDL. HHSC sent the STAR plans PDL/PA program information early this week. Q. When will HHSC make a final decision regarding which behavioral health drugs will be included on the preferred drug list? A. HHSC’s PDL decision on antidepressants currently is posted on the HHSC Web site. HHSC has not set a specific date by which it will make a decision for atypical an
Related Questions
- Generally, rate codes are not used to bill Medicaid managed care plans. How should SAEs for Medicaid managed care enrollees be identified and billed?
- What steps have been taken to educate the Medicaid managed care plans about implementation of the PDL?
- How do Medicare managed care plans work when an individual has Medicaid?
