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MARYLAND MEDICAID HEALTHCHOICE: FORMULARY EMERGENCY SUPPLY POLICIES AND PROCEDURES FOR MANAGED CARE ORGANIZATIONS Managed Care Organization (MCO) AMERIGROUP Community Care×Kaiser Permanent×Number
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Maryland Medicaid HealthChoice Non-Formulary is a list of prescription drugs that require prior authorization for coverage under the Medicaid program.
Healthcare providers and pharmacies are required to file Maryland Medicaid HealthChoice Non-Formulary when prescribing or dispensing drugs on the list.
Maryland Medicaid HealthChoice Non-Formulary can be filled out electronically through the Maryland Medicaid provider portal or submitted via paper form.
The purpose of Maryland Medicaid HealthChoice Non-Formulary is to ensure proper utilization of prescription drugs and control costs.
The information reported on Maryland Medicaid HealthChoice Non-Formulary includes the drug name, dose, duration of therapy, diagnosis, and justification for use.
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