Manuals
| Item | Last Modified |
|---|---|
| Pharmacy Provider Billing Manual | 12/07/2017 |
| Trading Partners FTP Instructions | 05/29/2018 |
| MEUPS Provider Sign-in Instructions | 06/25/2014 |
| Web Claim Submission (WCS) User Guide | 06/27/2014 |
Payer Specs
| 2015 | Last Modified |
|---|---|
| D.0 Payer Specs | 11/11/2015 |
Drug Lists
| Item | Last Modified |
|---|---|
| Diabetic Supply Preferred Drug List (effective 10/01/2017) | 09/27/2017 |
Contacts
- Prior Authorization
1-800-477-3071 - Claim Inquiry
1-800-432-7005
Please note questions regarding claims prior to October 5, 2010 should be directed to 1-800-807-1232.
Education
| Title | Last Modified |
|---|---|
| Diabetic Supply FAQs | 04/03/2015 |
Provider Notices
| Title | Description | Last Modified |
|---|---|---|
| Pharmacy Provider Notice #110 | Diabetic Supplies | 09/17/2010 |
Drug Management Review Advisory Board
| Item | Last Modified |
|---|---|
| Information about the Drug Management Review Advisory Board | External URL |
Forms
| Item | Last Modified |
|---|---|
| DMRAB Speaker Request Form - PDF | 12/04/2015 |
| DMRAB Speaker Request Form - Word | 12/04/2015 |
This Year’s Meetings
| June 7, 2018 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| March 8, 2018 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
Previous Year’s Meetings
| March 9, 2017 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
Member List
| Item | Last Modified |
|---|---|
| DMRAB Member List | 12/04/2015 |
Directions
| Item | Last Modified |
|---|---|
| Capitol Annex Directions | 06/09/2014 |
| Frankfort, KY Map | 04/26/2010 |
Drug Management Review Advisory Board Archives
| March 10, 2016 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| September 10, 2015 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| June 11, 2015 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| March 12, 2015 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| December 11, 2014 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| September 11, 2014 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| June 12, 2014 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| March 13, 2014 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| November 14, 2013 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| August 08, 2013 | Last Modified |
|---|---|
| Agenda | 07/24/2013 |
| Cancelled due to lack of quorum | N/A |
| May 09, 2013 | Last Modified |
|---|---|
| Agenda | 04/22/2013 |
| Cancelled due to lack of quorum | N/A |
| February 14, 2013 | Last Modified |
|---|---|
| Agenda | 01/28/2013 |
| Cancelled due to lack of quorum | N/A |
| November 08, 2012 | Last Modified |
|---|---|
| Agenda | 10/17/2012 |
| Recommendations for Consideration | 10/17/2012 |
| Cancelled due to lack of quorum | N/A |
| August 09, 2012 | Last Modified |
|---|---|
| Agenda | 07/24/2012 |
| Recommendations for Consideration | 07/24/2012 |
| Cancelled due to lack of quorum | N/A |
| May 10, 2012 | Last Modified |
|---|---|
| Agenda | 04/24/2012 |
| Recommendations for Consideration | 04/24/2012 |
| Cancelled due to lack of quorum | N/A |
| February 09, 2012 | Last Modified |
|---|---|
| Agenda | 01/24/2012 |
| Recommendations for Consideration | 01/24/2012 |
| Cancelled due to lack of quorum | N/A |
| November 10, 2011 | Last Modified |
|---|---|
| Agenda | 10/27/2011 |
| Recommendations for Consideration | 10/27/2011 |
| Cancelled due to lack of quorum | N/A |
| August 11, 2011 | Last Modified |
|---|---|
| Agenda | 07/25/2011 |
| Committee Recommendations | 12/02/2011 |
| Final Decisions | 12/02/2011 |
| May 12, 2011 | Last Modified |
|---|---|
| Agenda | 04/22/2011 |
| Minutes | 08/18/2011 |
| Presentation | 08/16/2011 |
| Drug to Drug Interactions Recommendations | 04/22/2011 |
| February 10, 2011 | Last Modified |
|---|---|
| Agenda | 01/26/2011 |
| Drug to Drug Interactions Recommendations | 01/26/2011 |
| Cancelled due to lack of quorum | N/A |
| November 04, 2010 | Last Modified |
|---|---|
| Agenda | 10/19/2010 |
| Minutes | 08/18/2011 |
| Presentation | 05/20/2011 |
| August 12, 2010 | Last Modified |
|---|---|
| Agenda | 07/26/2010 |
| Minutes | 08/18/2011 |
| Presentation | 11/24/2010 |
| May 13, 2010 | Last Modified |
|---|---|
| Agenda | 11/24/2010 |
| Minutes | 11/24/2010 |
| Presentation | 11/24/2010 |
General Information
Drug Information
| Item | Last Modified |
|---|---|
| Covered Prescription Cold, Cough, and Vitamin Product List (effective 04/15/2014) | 05/05/2015 |
| Maximum Quantity Limits List | current |
| Over-The-Counter (OTC) Drug List | current |
| Preferred Drug List (PDL) | current |
| Kentucky Medicaid Diagnosis Drug List | current |
Kentucky Medicaid Active Labelers
| 2018 | Last Modified |
|---|---|
| Active Labelers 1Q2018 | 06/06/2018 |
Drug Information Archives
| 2017 | Last Modified |
|---|---|
| Active Labelers 4Q2017 | 02/26/2018 |
| Active Labelers 3Q2017 | 02/26/2018 |
| Active Labelers 2Q2017 | 08/16/2017 |
| Active Labelers 1Q2017 | 08/16/2017 |
| 2016 | Last Modified |
|---|---|
| Active Labelers 4Q2016 | 08/16/2017 |
| Active Labelers 3Q2016 | 01/11/2017 |
| Active Labelers 2Q2016 | 09/09/2016 |
| Active Labelers 1Q2016 | 09/09/2016 |
| 2015 | Last Modified |
|---|---|
| Active Labelers 4Q2015 | 05/10/2016 |
| Active Labelers 3Q2015 | 01/06/2016 |
| Active Labelers 2Q2015 | 10/14/2015 |
| Active Labelers 1Q2015 | 07/07/2015 |
| 2014 | Last Modified |
|---|---|
| Active Labelers 4Q2014 | 04/03/2015 |
| Active Labelers 3Q2014 | 01/06/2015 |
| Active Labelers 2Q2014 | 01/06/2015 |
| Active Labelers 1Q2014 | 07/10/2014 |
| 2013 | Last Modified |
|---|---|
| Active Labelers 4Q2013 | 04/29/2014 |
| Active Labelers 3Q2013 | 04/29/2014 |
| Active Labelers 2Q2013 | 04/29/2014 |
| Active Labelers 1Q2013 | 07/05/2013 |
| 2012 | Last Modified |
|---|---|
| Active Labelers 4Q2012 | 03/25/2013 |
| Active Labelers 3Q2012 | 12/11/2012 |
| Active Labelers 2Q2012 | 08/27/2012 |
| Active Labelers 1Q2012 | 05/24/2012 |
| 2011 | Last Modified |
|---|---|
| Active Labelers 4Q2011 | 03/01/2012 |
| Active Labelers 3Q2011 | 01/17/2012 |
| Active Labelers 2Q2011 | 08/18/2011 |
| Active Labelers 1Q2011 | 07/14/2011 |
Maximum Allowable Cost
| Title | Last Modified |
|---|---|
| Maximum Allowable Cost (MAC) list | Monthly Update |
| Maximum Allowable Cost (MAC) Listing - (Weekly Changes) | Wednesday Update |
| MAC Price Research Request Form | 10/03/2012 |
Provider Notifications
| Title | Description | Last Modified |
|---|---|---|
| Pharmacy Quarterly Newsletter | Volume 2, Number 1 | 02/16/2011 |
| Pharmacy Provider Notice #120 | NCPDP Version D.0 | 01/06/2011 |
| Pharmacy Quarterly Newsletter | Volume 1, Number 1 | 11/09/2010 |
Education
| Title | Description | Last Modified |
|---|---|---|
| https://questions.cms.gov/ | CMS Website - Frequently Asked Questions Use "Search" feature to look-up D.0/5010 information | 11/11/2010 |
| NCPDP D.0 FAQs | Kentucky Medicaid's Frequently Asked Questions | 11/14/2011 |
NCPDP Resources
| Title | Description | Last Modified |
|---|---|---|
| https://www.ncpdp.org | NCPDP Website - To purchase implementation guides and access technical questions | 11/11/2010 |
| http://www.ncpdp.org/NCPDP/media/pdf/VersionDQuestionsv26.pdf | NCPDP Website - Version D Editorial | 11/11/2010 |
CMS Resources
| Title | Description | Last Modified |
|---|---|---|
| http://www.cms.gov/Versions5010andD0 | CMS Website - Central Version 5010 and D.0 Webpage | 11/11/2010 |
| http://www.cms.gov/Versions5010andD0/40_Educational_Resources.asp | CMS Website - Educational Resources | 11/11/2010 |
| http://www.cms.gov/MFFS5010D0 | CMS Website - Dedicated HIPAA 5010/D.0 Project Web Page | 11/11/2010 |
| http://www.cms.gov/TransactionCodeSetsStands/ | CMS Website - Transactions and Code Sets Standards | 11/11/2010 |
Additional Resources
| Title | Description | Last Modified |
|---|---|---|
| http://www.hipaa-dsmo.org | Designated Standard Maintenance Organizations (DSMO) Website - Request changes to standards | 11/11/2010 |
Presentations
| Title | Last Modified |
|---|---|
| Kentucky Medicaid Pharmacy 3Q2012 Webinar | 11/02/2012 |
| Kentucky Medicaid Pharmacy 1Q2011 Webinar | 03/30/2011 |
Current Notices
| Title | Description | Last Modified |
|---|---|---|
| Fee-for-Service Pharmacy Provider Notice #227 | Opioid Class Criteria Changes | 06/15/2018 |
| Fee-for-Service Pharmacy Provider Notice #226 | March 2018 PDL Changes | 06/15/2018 |
| Fee-for-Service Pharmacy Provider Notice #225 | November 2017 PDL Changes | 06/01/2018 |
| Fee-for-Service Pharmacy Provider Notice #224 | May 2017 PDL Changes | 06/01/2018 |
| Fee-for-Service Pharmacy Provider Notice #223 | March 2017 PDL Changes | 12/14/2017 |
| Fee-for-Service Pharmacy Provider Notice #222 | Preferred Drug Status Changes | 12/01/2017 |
| Fee-For-Service Pharmacy Provider Notice #221 | State Maximum Allowable Cost Price Error | 06/26/2017 |
| Fee-For-Service Pharmacy Provider Notice #220 | Universal Prescription Drug PA Request Forms | 05/16/2017 |
| Fee-For-Service Pharmacy Provider Notice #219 | Actual Acquisition Cost Reimbursement for Fee-for-Service Covered Outpatient Drugs | 05/16/2017 |
| Fee-For-Service Pharmacy Provider Notice #218 | Departments Message Concerning Pharmacy Reimbursement | 03/27/2017 |
| Fee-For-Service Pharmacy Provider Notice #217 | Narcan® Nasal Spray (naloxone HCl) | 12/19/2016 |
| Fee-For-Service Pharmacy Provider Notice #216 | March 2016 PDL Changes | 12/19/2016 |
| Fee-For-Service Pharmacy Provider Notice #215 | January 2016 PDL Changes | 12/19/2016 |
| Fee-For-Service Pharmacy Provider Notice #214 | Non-Rebate Eligible Products | 11/04/2016 |
| Fee-For-Service Pharmacy Provider Notice #213 | Non-Rebate Eligible Products | 09/09/2016 |
| Fee-For-Service Pharmacy Provider Notice #212 | Non-Rebate Eligible Products | 09/09/2016 |
| Fee-For-Service Pharmacy Provider Notice #211 | November 19, 2015 P&T PDL Changes | 05/10/2016 |
| Fee-For-Service Pharmacy Provider Notice #210 | Departments Message Concerning Benefind | 03/31/2016 |
| Fee-For-Service Pharmacy Provider Notice #209 | November/December/January Pharmacy Updates and Upcoming Changes | 03/04/2016 |
| Fee-For-Service Pharmacy Provider Notice #208 | September 17, 2015 P & T PDL Changes | 01/06/2016 |
Historical Notices
| Title | Description | Last Modified |
|---|---|---|
| Fee-For-Service Pharmacy Provider Notice #207 | Senate Bill 44 (Medication Synchronization) | 12/04/2015 |
| Fee-For-Service Pharmacy Provider Notice #206 | October Pharmacy Updates and Upcoming Changes | 12/04/2015 |
| Fee-For-Service Pharmacy Provider Notice #205 | September Pharmacy Updates and Upcoming Changes | 10/14/2015 |
| Fee-For-Service Pharmacy Provider Notice #204 | July 16, 2015 P & T PDL Changes | 10/14/2015 |
| Fee-For-Service Pharmacy Provider Notice #203 | August Pharmacy Updates and Upcoming Changes | 09/24/2015 |
| Fee-For-Service Pharmacy Provider Notice #202 | July Pharmacy Updates and Upcoming Changes | 08/19/2015 |
| Fee-For-Service Pharmacy Provider Notice #201 | May 21, 2015 P & T PDL Changes | 07/28/2015 |
| Fee-For-Service Pharmacy Provider Notice #200 | May/June Pharmacy Updates and Upcoming Changes | 07/14/2015 |
| Fee-For-Service Pharmacy Provider Notice #199 | March 19, 2015 P & T PDL Changes | 05/13/2015 |
| Fee-For-Service Pharmacy Provider Notice #198 | April Pharmacy Updates | 05/05/2015 |
| Fee-For-Service Pharmacy Provider Notice #197 | March Pharmacy Updates | 04/21/2015 |
| Fee-For-Service Pharmacy Provider Notice #196 | Pharmacy Drug Pricing & Reimbursement | 04/03/2015 |
| Fee-For-Service Pharmacy Provider Notice #195 | Tobacco Cessation Changes | 04/03/2015 |
| Fee-For-Service Pharmacy Provider Notice #194 | February Pharmacy Updates and Upcoming Changes | 03/16/2015 |
| Fee-For-Service Pharmacy Provider Notice #193 | January 15, 2015 P&T PDL Changes | 03/02/2015 |
| Fee-For-Service Pharmacy Provider Notice #192 | January Pharmacy Updates and Upcoming Changes | 02/18/2015 |
| Fee-For-Service Pharmacy Provider Notice #191 | December Pharmacy Updates and Upcoming Changes | 01/09/2015 |
| Fee-For-Service Pharmacy Provider Notice #190 | November 20, 2014 P&T PDL Changes | 01/09/2015 |
| Fee-For-Service Pharmacy Provider Notice #189 | October and November Pharmacy Updates and Upcoming Changes | 12/22/2014 |
| Fee-For-Service Pharmacy Provider Notice #188 | September 18, 2014 P&T PDL Changes | 11/06/2014 |
| Fee-For-Service Pharmacy Provider Notice #187 | September Pharmacy Updates | 10/15/2014 |
| Fee-For-Service Pharmacy Provider Notice #186 | August Pharmacy Updates | 09/23/2014 |
| Fee-For-Service Pharmacy Provider Notice #185 | July Pharmacy Updates | 08/15/2014 |
| Fee-For-Service Pharmacy Provider Notice #184 | Cost-Sharing Update | 07/23/2014 |
| Fee-For-Service Pharmacy Provider Notice #183 | June Pharmacy Updates | 07/23/2014 |
| Fee-For-Service Pharmacy Provider Notice #182 | March 20, 2014 P&T PDL Changes | 07/10/2014 |
| Fee-For-Service Pharmacy Provider Notice #181 | May Pharmacy Updates and Upcoming Changes | 06/13/2014 |
| Fee-For-Service Pharmacy Provider Notice #180 | Web Portal Announcement | 06/06/2014 |
| Fee-For-Service Pharmacy Provider Notice #179 | April Pharmacy Updates and Upcoming Changes | 05/30/2014 |
| Fee-For-Service Pharmacy Provider Notice #178 | March Pharmacy Updates and Upcoming Changes | 04/17/2014 |
| Fee-For-Service Pharmacy Provider Notice #177 | February Pharmacy Updates and Upcoming Changes | 03/12/2014 |
| Fee-For-Service Pharmacy Provider Notice #176 | January Pharmacy Updates and Upcoming Changes | 02/13/2014 |
| Fee-For-Service Pharmacy Provider Notice #175 | November 21, 2013 PTAC PDL Changes | 02/13/2014 |
| Fee-For-Service Pharmacy Provider Notice #174 | December Pharmacy Updates and Upcoming Changes | 01/14/2014 |
| Fee-For-Service Pharmacy Provider Notice #173 | September 19, 2013 PTAC PDL Changes | 01/06/2014 |
| Fee-For-Service Pharmacy Provider Notice #172 | 2014 Plan Design Changes | 12/16/2013 |
| Fee-For-Service Pharmacy Provider Notice #171 | November Pharmacy Updates and Upcoming Changes | 12/10/2013 |
| Fee-For-Service Pharmacy Provider Notice #170 | October Pharmacy Updates and Upcoming Changes | 11/07/2013 |
| Fee-For-Service Pharmacy Provider Notice #169 | September Updates | 10/10/2013 |
| Fee-For-Service Pharmacy Provider Notice #168 | August Pharmacy Updates and Upcoming Changes | 09/16/2013 |
| Fee-For-Service Pharmacy Provider Notice #167 | July Pharmacy Updates and Upcoming Changes | 09/10/2013 |
| Fee-For-Service Pharmacy Provider Notice #166 | June Pharmacy Updates | 08/08/2013 |
| Fee-For-Service Pharmacy Provider Notice #165 | Upcoming Pharmacy Updates | 07/16/2013 |
| Fee-For-Service Pharmacy Provider Notice #164 | March 21, 2013 PTAC PDL Changes | 07/16/2013 |
| Fee-For-Service Pharmacy Provider Notice #163 | May Updates | 06/27/2013 |
| Fee-For-Service Pharmacy Provider Notice #162 | April Updates and Upcoming Changes | 05/17/2013 |
| Fee-For-Service Pharmacy Provider Notice #161 | March Pharmacy Updates | 05/03/2013 |
| Fee-For-Service Pharmacy Provider Notice #160 | February Pharmacy Updates | 03/27/2013 |
| Fee-For-Service Pharmacy Provider Notice #159 | January Pharmacy Updates | 02/28/2013 |
| Fee-For-Service Pharmacy Provider Notice #158 | November 15, 2012 PTAC PDL Changes | 01/21/2013 |
| Fee-For-Service Pharmacy Provider Notice #157 | December Updates and Upcoming Changes | 01/11/2013 |
| Fee-For-Service Pharmacy Provider Notice #156 | November Pharmacy Updates | 12/21/2012 |
| Fee-For-Service Pharmacy Provider Notice #155 | October Pharmacy Updates and Upcoming Changes | 11/30/2012 |
| Fee-For-Service Pharmacy Provider Notice #154 | September Pharmacy Updates | 10/25/2012 |
| Fee-For-Service Pharmacy Provider Notice #153 | July 19, 2012 PTAC PDL Changes | 09/27/2012 |
| Fee-For-Service Pharmacy Provider Notice #152 | August Pharmacy Updates | 09/19/2012 |
| Fee-For-Service Pharmacy Provider Notice #151 | July Pharmacy Updates | 08/30/2012 |
| Fee-For-Service Pharmacy Provider Notice #150 | June Pharmacy Updates | 08/01/2012 |
| Fee-For-Service Pharmacy Provider Notice #149 | May Pharmacy Updates and Upcoming Changes | 06/15/2012 |
| Fee-For-Service Pharmacy Provider Notice #148 | Upcoming Changes for Cold, Cough, and Vitamin Prescriptions | 05/25/2012 |
| Fee-For-Service Pharmacy Provider Notice #147 | April Pharmacy Updates | 05/22/2012 |
| Fee-For-Service Pharmacy Provider Notice #146 | March 15, 2012 PTAC PDL Changes — effective beginning 06/06/2012 | 05/10/2012 |
| Fee-For-Service Pharmacy Provider Notice #145 | March Pharmacy Updates | 04/26/2012 |
| Fee-For-Service Pharmacy Provider Notice #144 | February Pharmacy Updates | 03/26/2012 |
| Pharmacy Provider Notice #143 | Upcoming Pharmacy Changes | 03/01/2012 |
| Pharmacy Provider Notice #142 | January Updates | 03/01/2012 |
| Pharmacy Provider Notice #141 | December Updates and Upcoming Changes | 01/27/2012 |
| Pharmacy Provider Notice #140 | October Updates and Upcoming Changes | 11/21/2011 |
| Pharmacy Provider Notice #139 | September Updates | 10/26/2011 |
| Pharmacy Provider Notice #138 | July 21, 2011 PTAC PDL Changes | 09/28/2011 |
| Pharmacy Provider Notice #137 | August Updates | 09/21/2011 |
| Pharmacy Provider Notice #136 | Average Whole Price (AWP) to Wholesale Acquisition Cost (WAC) | 09/30/2011 |
| Pharmacy Provider Notice #135 | July Updates and Upcoming Changes | 08/19/2011 |
| Pharmacy Provider Notice #134 | May 19, 2011 PTAC PDL Changes — effective beginning 08/24/2011 | 07/22/2011 |
| Pharmacy Provider Notice #133 | June Updates and Upcoming Changes | 07/11/2011 |
| Pharmacy Provider Notice #132 | Reminder for NCPDP Version D.0 Implementation | 06/29/2011 |
| Pharmacy Provider Notice #131 | April and May Updates and Upcoming Changes | 06/15/2011 |
| Pharmacy Provider Notice #130 | Non-Medicaid Providers Edit | 06/09/2011 |
| Pharmacy Provider Notice #129 | March 17, 2011 PTAC PDL Changes — effective beginning 06/15/2011 | 05/20/2011 |
| Pharmacy Provider Notice #128 | Atypical Antipsychotics PTAC PDL Changes from the 11/18/2010 PTAC Meeting | 05/06/2011 |
| Pharmacy Provider Notice #127 | March Updates and Upcoming Changes | 04/22/2011 |
| Pharmacy Provider Notice #126 | Retraction to Pharmacy Provider Notice #125 | 04/13/2011 |
| Pharmacy Provider Notice #125 | Atypical Antipsychotics PDL Changes from the November 2010 PTAC Meeting | 03/08/2011 |
| Pharmacy Provider Notice #124 | February Pharmacy Updates | 03/04/2011 |
| Pharmacy Provider Notice #123 | January Pharmacy Updates and Upcoming Changes | 02/16/2011 |
| Pharmacy Provider Notice #122 | Multi-Ingredient Compound Billing | 01/26/2011 |
| Pharmacy Provider Notice #121 | December Pharmacy Updates | 01/26/2011 |
| Pharmacy Provider Notice #120 | NCPDP Version D.0 | 01/06/2011 |
| Pharmacy Provider Notice #119 | November 18, 2010 PTAC PDL Changes - effective beginning 02/08/2011 | 01/06/2011 |
| Pharmacy Provider Notice #118 | November Pharmacy Updates and Upcoming Changes | 12/21/2010 |
| Pharmacy Provider Notice #117 | October Pharmacy Updates and Upcoming Changes | 11/29/2010 |
| Pharmacy Provider Notice #116 | Tobacco Cessation Program Coverage | 12/01/2010 |
| Pharmacy Provider Notice #115 | PDL Changes September 2010 PTAC Meeting — effective beginning 12/01/2010 | 11/01/2010 |
| Pharmacy Provider Notice #114 | September Updates and Changes | 11/01/2010 |
| Pharmacy Provider Notice #113 | Tobacco Cessation — 3 Brand/4 Script Limitations | 10/19/2010 |
| Pharmacy Provider Notice #112 | UPDATE: Non-Medicaid Prescribers | 09/30/2010 |
| Pharmacy Provider Notice #111 | August Pharmacy Updates | 09/24/2010 |
| Pharmacy Provider Notice #110 | Diabetic Supplies | 09/17/2010 |
| Pharmacy Provider Notice #109 | July Pharmacy Updates | 08/18/2010 |
| Pharmacy Provider Notice #108 | PDL Changes from May 2010 PTAC Meeting — effective beginning 09/08/2010 | 08/05/2010 |
| Pharmacy Provider Notice #107 | Early Refill and OTC Changes | 07/22/2010 |
| Pharmacy Provider Notice #106 | June Pharmacy Updates | 07/14/2010 |
| Pharmacy Provider Notice #105 | Pharmacy License Update | 07/12/2010 |
| Pharmacy Provider Notice #104 | Upcoming Pharmacy Changes | 07/07/2010 |
| Pharmacy Provider Notice #103 | May Updates & Norditropin FlexPro | 06/11/2010 |
| Pharmacy Provider Notice #102 | Retraction to Provider Notice #099 - April Pharmacy Updates | 05/27/2010 |
| Pharmacy Provider Notice #101 | PDL Changes from March 2010 PTAC - beginning 06/23/2010 | 05/19/2010 |
| Pharmacy Provider Notice #099 | April Pharmacy Updates | 05/07/2010 |
| Pharmacy Provider Notice #098 | PDL Changes from November PTAC Meeting — effective 05/19/2010 & March Updates | 04/14/2010 |
| Pharmacy Provider Notice #097 | PDL Changes from November PTAC Meeting — effective 05/12/2010 | 04/07/2010 |
| Pharmacy Provider Notice #096 | PDL Changes from November PTAC Meeting — effective 05/05/2010 | 04/01/2010 |
| Pharmacy Provider Notice #095 | PDL Changes From November PTAC Meeting - effective 04/28/2010 & DiaStat QL | 03/26/2010 |
| Pharmacy Provider Notice #094 | February Pharmacy Updates | 03/12/2010 |
| Pharmacy Provider Notice #093 | PDL Changes from September PTAC Meeting — effective 04/14/2010 & 04/21/2010 | 03/12/2010 |
| Pharmacy Provider Notice #092 | PDL Changes from September PTAC Meeting — effective 03/31/2010 & 04/07/2010 | 03/05/2010 |
| Pharmacy Provider Notice #091 | PDL Changes from September PTAC Meeting — effective 03/17/2010 & 03/24/2010 | 02/17/2010 |
| Pharmacy Provider Notice #090 | Retraction to Provider Notice #89 - December Pharmacy Updates | 02/05/2010 |
| Pharmacy Provider Notice #089 | December Pharmacy Updates | 01/29/2010 |
| Pharmacy Provider Notice #088 | PDL Changes from July PTAC Meeting - effective 01/27/2010 (November 2009 Updates) | 12/23/2009 |
| Pharmacy Provider Notice #087 | PDL Changes from July PTAC Meeting - effective 01/20/2010 | 12/18/2009 |
| Pharmacy Provider Notice #086 | PDL Changes from July PTAC Meeting - effective 01/13/2010 | 12/11/2009 |
| Pharmacy Provider Notice #085 | October Pharmacy Updates | 12/01/2009 |
| Pharmacy Provider Notice #084 | PDL Changes from April PTAC Meeting - effective 12/02/2009 | 11/02/2009 |
| Pharmacy Provider Notice #083 | PDL Changes from April PTAC Meeting - effective 11/18/2009 | 10/16/2009 |
| Pharmacy Provider Notice #082 | PDL Changes from April PTAC Meeting - effective 11/11/2009 | 10/12/2009 |
| Pharmacy Provider Notice #081 | September Pharmacy Updates | 10/08/2009 |
| Pharmacy Provider Notice #080 | PDL Changes from March PTAC Meeting - effective 10/28/2009 | 09/25/2009 |
| Pharmacy Provider Notice #079 | PDL Changes from March PTAC Meeting — effective 10/21/2009 | 09/17/2009 |
| Pharmacy Provider Notice #078 | PDL Changes from March PTAC Meeting — effective 10/14/2009 / August Updates | 09/11/2009 |
| Pharmacy Provider Notice #077 | PDL Changes from March PTAC Meeting — effective 10/07/2009 | 09/03/2009 |
| Pharmacy Provider Notice #076 | Synagis Change | 08/26/2009 |
| Pharmacy Provider Notice #075 | July Pharmacy Updates | 08/21/2009 |
| Pharmacy Provider Notice #074 | June Pharmacy Updates | 08/10/2009 |
| Pharmacy Provider Notice #073 | Prevacid SoluTab Change | 07/24/2009 |
| Pharmacy Provider Notice #072 | Invega Change | 07/07/2009 |
| Pharmacy Provider Notice #071 | May Pharmacy Updates | 06/12/2009 |
| Pharmacy Provider Notice #070 | April Pharmacy Updates | 05/22/2009 |
| Pharmacy Provider Notice #069 | March Pharmacy Updates | 05/22/2009 |
| Pharmacy Provider Notice #068 | PDL Changes from Oct/Nov PTAC Meetings | 05/07/2009 |
| Pharmacy Provider Notice #067 | February Pharmacy Updates | 04/01/2009 |
| Pharmacy Provider Notice #066 | January Pharmacy Updates | 03/04/2009 |
| Pharmacy Provider Notice #065 | (Replaces Provider Notice #64) NPI Final Implementation Phase Update | 02/19/2009 |
| Pharmacy Provider Notice #064 | NPI Final Implementation Phase | 02/05/2009 |
| Pharmacy Provider Notice #063 | October Pharmacy Updates | 11/17/2008 |
| Pharmacy Provider Notice #062 | Prescriber NPI Notification | 10/08/2008 |
| Pharmacy Provider Notice #061A | Tamper-Resistant Prescription Pad Update | 02/15/2011 |
| Pharmacy Provider Notice #061 | Levaquin Change | 09/11/2008 |
| Pharmacy Provider Notice #060 | Lipitor Change | 08/26/2008 |
| Pharmacy Provider Notice #059 | Payment Cycle Notice | 05/30/2008 |
| Pharmacy Provider Notice #058A | Tamper-Resistant Prescription Pad Policy Clarification | 10/07/2009 |
| Pharmacy Provider Notice #058 | NPI Notification | 04/16/2008 |
| Pharmacy Provider Notice #057A | Tamper-Resistant Prescription Pad Pharmacist Fact Sheet | 02/15/2011 |
| Pharmacy Provider Notice #057 | Tamper-Resistant Prescription Pad Update | 03/25/2008 |
| Pharmacy Provider Notice #056 | Spiriva Change | 12/28/2007 |
| Pharmacy Provider Notice #055 | Revised Kentucky Mental Health Chart | 11/01/2007 |
| Pharmacy Provider Notice #054 | Tamper-Resistant Prescription Pad Requirements (Includes FAQ & Answers) | 09/18/2007 |
| Pharmacy Provider Notice #053 | Recent and Upcoming Preferred Drug List Changes | 09/14/2007 |
| Pharmacy Provider Notice #052 | Pharmacy License Update Reminder — Replacing Provider Notice #051 | 08/29/2007 |
| Pharmacy Provider Notice #051 | Pharmacy License Update Reminder | 08/07/2007 |
| Pharmacy Provider Notice #050 | Recent and Upcoming Preferred Drug List Changes | 07/25/2007 |
| Pharmacy Provider Notice #049 | Mirapex Change | 07/16/2007 |
| Pharmacy Provider Notice #048 | Recent and Upcoming Preferred Drug List Changes | 05/07/2007 |
| Pharmacy Provider Notice #047 | National Provider Identifier (NPI) Information | 05/02/2007 |
| Pharmacy Provider Notice #046 | Pharmacy Provider Payment | 04/17/2007 |
| Pharmacy Provider Notice #045 | Recent and Upcoming Preferred Drug List Changes | 04/10/2007 |
| Pharmacy Provider Notice #044 | Federal Poverty Level Indicator | 03/09/2007 |
| Pharmacy Provider Notice #043 | Updated Mental Health Provider Quick Reference — replacing Provider Notice #039 | 02/21/2007 |
| Pharmacy Provider Notice #042 | Recent and Upcoming Preferred Drug List Changes | 02/08/2007 |
| Pharmacy Provider Notice #041 | Recent and Upcoming Preferred Drug List Changes | 01/22/2007 |
| Pharmacy Provider Notice #040 | Zocor/simvastatin Changes | 01/04/2007 |
| Pharmacy Provider Notice #039 | Updated Mental Health Provider Quick Reference - Replacing Provider Notice #031 | 11/16/2006 |
| Pharmacy Provider Notice #038 | Drug Exclusion List for 4-Prescription Drug Limit | 11/14/2006 |
| Pharmacy Provider Notice #037 | Tier 3 Pharmacy Copayment Limited to $20 Maximum | 09/26/2006 |
| Pharmacy Provider Notice #036 | Pregnancy Indicator, Thyroid Exclusion, & Plavix Generics | 09/18/2006 |
| Pharmacy Provider Notice #035 | Billing Units and PDL Updates | 09/05/2006 |
| Pharmacy Provider Notice #034 | 4-Prescription Limit & 3-Brand Allowance Changes | 08/18/2006 |
| Pharmacy Provider Notice #033 | KyHealth Choices Fax Number Update | 07/20/2006 |
| Pharmacy Provider Notice #032 | Four Prescription Limit Audit Update | 07/21/2006 |
| Pharmacy Provider Notice #031 | Updated Mental Health Quick Reference — Replacing Provider Notice #026 | 07/19/2006 |
| Pharmacy Provider Notice #030 | Member Cost Sharing Policy Update | 07/12/2006 |
| Pharmacy Provider Notice #029 | June Provider Payment Change | 06/20/2006 |
| Pharmacy Provider Notice #028 | Prescribing Antidepressants | 06/15/2006 |
| Pharmacy Provider Notice #027 | KyHealth Choices Co-Payment Changes | 06/02/2006 |
| Pharmacy Provider Notice #026 | Updated Mental Health Quick Reference — Replacing Provider Notice #018 | 06/02/2006 |
| Pharmacy Provider Notice #025 | Out-of-Pocket Maximum Misprint | 05/22/2006 |
| Pharmacy Provider Notice #024 | Drug Updates: Revatio, Zofran, Anzemet, and Omeprazole | 04/27/2006 |
| Pharmacy Provider Notice #023 | Prior Authorization Process for 4 Script Limit | 03/23/2006 |
| Pharmacy Provider Notice #022 | 4 Prescription Drug Limit Clarification | 02/28/2006 |
| Pharmacy Provider Notice #021 | 4 Prescription Drug Limit | 02/09/2006 |
| Pharmacy Provider Notice #020 | Preferred Drug List Changes | 02/10/2006 |
| Pharmacy Provider Notice #019 | Revised MAC List | 01/13/2006 |
| Pharmacy Provider Notice #018 | Mental Health Quick Reference | 12/20/2005 |
| Pharmacy Provider Notice #017 | Preferred Drug List Changes | 12/15/2005 |
| Pharmacy Provider Notice #016 | Medicaid to Medicare Part D Transition | 12/07/2005 |
| Pharmacy Provider Notice #015 | Accolate, Singulair & Xopenex Update | 12/06/2005 |
| Pharmacy Provider Notice #014 | 08/31/2005 | |
| Pharmacy Provider Notice #013 | 08/01/2005 | |
| Pharmacy Provider Notice #012A | Long Term Care Billing for Scheduled Drugs | 12/14/2005 |
| Pharmacy Provider Notice #012 | 02/28/2005 | |
| Pharmacy Provider Notice #011 | 02/08/2005 | |
| Pharmacy Provider Notice #010 | 01/12/2005 | |
| Pharmacy Provider Notice #009 | 12/23/2004 | |
| Pharmacy Provider Notice #008 | 12/21/2004 | |
| Pharmacy Provider Notice #007 | 12/21/2004 | |
| Pharmacy Provider Notice #006 | 12/17/2004 | |
| Pharmacy Provider Notice #005 | 12/14/2004 | |
| Pharmacy Provider Notice #004 | 12/09/2004 | |
| Pharmacy Provider Notice #003 | 12/09/2004 | |
| Pharmacy Provider Notice #002 | 11/15/2004 |
PAD
Drug Information
| Item | Last Modified |
|---|---|
| Physician Administered Drug (PAD) List | External URL |
Billing Instructions
| Item | Last Modified |
|---|---|
| Billing Instructions | External URL |
Education
| Item | Last Modified |
|---|---|
| Physician Administered Drug List Tutorial | 12/07/2017 |
| Physician Administered Drug List FAQs | 12/07/2017 |
Provider Notices
| Title | Last Modified |
|---|---|
| Department for Medicaid Services | External URL |
Additional Resources
| Title | Last Modified |
|---|---|
| For a list of HCPCS codes please refer to the following website: | External URL |
Contacts
| Resource | Contact |
|---|---|
| For questions regarding the submission of a claim, procedure code(s), remittance advice, and/or payment, please contact a DXC (formerly HPE) Provider Representative at: | (800) 807-1232 |
| If you have questions relating to rebates for physician administered drugs or NDC numbers, please contact Magellan Rx Management at: | rebate@magellanhealth.com |
| Title | Last Modified |
|---|---|
| Universal PA Request Form – All Others | 04/16/2018 |
| Universal PA Request Form – Buprenorphine | 04/16/2018 |
For telephonic prior authorization requests or inquiries regarding a prior authorization please call (800) 477-3071.
Please fax prior authorization requests to one of the following numbers —
Regular Fax Line:
800-365-8835
Urgent Requests:
800-421-9064
Nursing Facility:
800-453-2273
Mental Health Drugs:
800-453-2273
Denials and Appeals
- Only a patient or family member can appeal a prior authorization denial
- The member has 30 days from receipt of the denial letter to submit a written appeal to the address below:
- Kentucky Department for Medicaid Services
Division of Administration and Financial Management
Administrative Services Branch, 6W-C
275 East Main Street
Frankfort, KY 40621-0001
- Kentucky Department for Medicaid Services
- The prescribing physician can attend the appeal hearing and testify on the patient’s behalf
Pharmacy and Therapeutics Advisory Committee
| Item | Last Modified |
|---|---|
| Information about the Pharmacy and Therapeutics Advisory Committee | External URL |
Forms
| Item | Last Modified |
|---|---|
| P & T Speaker Request Form - PDF | 02/26/2018 |
| P & T Speaker Request Form - Word | 02/26/2018 |
This Year’s Meetings
| May 17, 2018 | Last Modified |
|---|---|
| Agenda | 05/03/2018 |
| Options | 05/07/2018 |
| Commissioner’s Final Decisions | 06/15/2018 |
| Committee Recommendations | 06/01/2018 |
| March 15, 2018 | Last Modified |
|---|---|
| Agenda | 02/26/2018 |
| Options | 02/26/2018 |
| Commissioner’s Final Decisions | 04/05/2018 |
| Committee Recommendations | 04/05/2018 |
Previous Year’s Meetings
| November 16, 2017 | Last Modified |
|---|---|
| Agenda | 11/02/2017 |
| Options | 11/02/2017 |
| Commissioner’s Final Decisions | 12/27/2017 |
| Committee Recommendations | 12/27/2017 |
| September 21, 2017 | Last Modified |
|---|---|
| Agenda | 09/12/2017 |
| Options | 09/12/2017 |
| Commissioner’s Final Decisions | 12/01/2017 |
| Committee Recommendations | 11/15/2017 |
| May 18, 2017 | Last Modified |
|---|---|
| Agenda | 04/28/2017 |
| Options | 04/28/2017 |
| Commissioner’s Final Decisions | 11/15/2017 |
| Committee Recommendations | 11/15/2017 |
| March 16, 2017 | Last Modified |
|---|---|
| Agenda | 03/16/2017 |
| Options | 03/16/2017 |
| Commissioner’s Final Decisions | 11/15/2017 |
| Committee Recommendations | 11/15/2017 |
Member List
| Title | Last Modified |
|---|---|
| P & T Member List | 03/06/2018 |
Directions
| Title | Last Modified |
|---|---|
| Capitol Annex Directions | 06/09/2014 |
| Frankfort, KY Map | 04/26/2010 |
Pharmacy and Therapeutics Advisory Committee Archives
| November 17, 2016 | Last Modified |
|---|---|
| Agenda | 11/04/2016 |
| Options | 11/04/2016 |
| Commissioner’s Final Decisions | 11/15/2017 |
| Committee Recommendations | 11/15/2017 |
| September 15, 2016 | Last Modified |
|---|---|
| Agenda | 08/23/2016 |
| Options | 08/23/2016 |
| Commissioner’s Final Decisions | 11/15/2017 |
| Committee Recommendations | 11/15/2017 |
| May 19, 2016 | Last Modified |
|---|---|
| Agenda | 05/10/2016 |
| Options | 05/10/2016 |
| Commissioner’s Final Decisions | 11/15/2017 |
| Committee Recommendations | 11/15/2017 |
| March 17, 2016 | Last Modified |
|---|---|
| Agenda | 03/04/2016 |
| Options | 03/04/2016 |
| Committee Recommendations | 01/11/2017 |
| Commissioner’s Final Decisions | 01/11/2017 |
| January 21, 2016 | Last Modified |
|---|---|
| Agenda | 01/21/2016 |
| Options | 01/21/2016 |
| Committee Recommendations | 01/11/2017 |
| Commissioner’s Final Decisions | 01/11/2017 |
| November 19, 2015 | Last Modified |
|---|---|
| Agenda | 05/10/2016 |
| Options | 05/10/2016 |
| Commissioner’s Final Decisions from November 19, 2015 | 05/10/2016 |
| Cancelled due to lack of quorum | N/A |
| September 17, 2015 | Last Modified |
|---|---|
| Agenda | 08/28/2015 |
| Options | 08/28/2015 |
| Commissioner’s Final Decisions from September 17, 2015 | 01/06/2016 |
| Cancelled due to lack of quorum | N/A |
| July 16, 2015 | Last Modified |
|---|---|
| Agenda | 06/30/2015 |
| Options | 06/30/2015 |
| Commissioner’s Final Decisions from July 16, 2015 | 09/16/2015 |
| May 21, 2015 | Last Modified |
|---|---|
| Agenda | 05/05/2015 |
| Options | 05/05/2015 |
| Commissioner’s Final Decisions from May 21, 2015 | 07/28/2015 |
| Cancelled due to lack of quorum | N/A |
| March 19, 2015 | Last Modified |
|---|---|
| Commissioner’s Final Decisions from March 19, 2015 | 04/21/2015 |
| Cancelled due to lack of quorum | N/A |
| January 15, 2015 | Last Modified |
|---|---|
| Commissioner’s Final Decisions from January 15, 2015 | 02/25/2015 |
| Cancelled due to lack of quorum | N/A |
| November 20, 2014 | Last Modified |
|---|---|
| Agenda | 11/06/2014 |
| Options | 11/06/2014 |
| Commissioner’s Final Decisions from November 20, 2014 | 12/16/2014 |
| Cancelled due to lack of quorum | N/A |
| September 18, 2014 | Last Modified |
|---|---|
| Agenda | 09/18/2014 |
| Options | 09/18/2014 |
| Commissioner’s Final Decisions from September 18, 2014 | 10/20/2014 |
| Cancelled due to lack of quorum | N/A |
| July 17, 2014 | Last Modified |
|---|---|
| Agenda | 07/17/2014 |
| Options | 07/17/2014 |
| Cancelled due to lack of quorum | N/A |
| May 15, 2014 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| March 20, 2014 | Last Modified |
|---|---|
| Agenda | 02/28/2014 |
| Options | 02/28/2014 |
| Committee Recommendations | 03/26/2014 |
| Commissioner’s Final Decisions from March 20, 2014 | 03/26/2014 |
| January 16, 2014 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| November 21, 2013 | Last Modified |
|---|---|
| Agenda | 10/31/2013 |
| Options | 10/31/2013 |
| Committee Recommendations | 11/27/2013 |
| Commissioners Final Decisions from November 21, 2013 | 02/03/2014 |
| September 19, 2013 | Last Modified |
|---|---|
| Agenda | 08/30/2013 |
| Options | 08/30/2013 |
| Committee Recommendations | 09/23/2013 |
| Commissioners Final Decisions from September 19, 2013 | 12/10/2013 |
| July 18, 2013 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| May 16, 2013 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| March 21, 2013 | Last Modified |
|---|---|
| Agenda | 03/05/2013 |
| Options | 03/11/2013 |
| Committee Recommendations | 03/27/2013 |
| Commissioners Final Decisions from March 21, 2013 | 07/05/2013 |
| January 17, 2013 | Last Modified |
|---|---|
| Agenda | 12/27/2012 |
| Options | 12/27/2012 |
| Cancelled due to lack of quorum | N/A |
| November 15, 2012 | Last Modified |
|---|---|
| Agenda | 10/30/2012 |
| Options | 10/30/2012 |
| Committee Recommendations | 11/21/2012 |
| Commisioner's Final Decisions from November 15, 2012 | 01/08/2013 |
| September 20, 2012 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| July 19, 2012 | Last Modified |
|---|---|
| Agenda | 06/27/2012 |
| Options | 06/27/2012 |
| Committee Recommendations | 07/24/2012 |
| Commisioner's Final Decisions from July 19, 2012 | 08/20/2012 |
| May 17, 2012 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| March 15, 2012 | Last Modified |
|---|---|
| Agenda | 02/27/2012 |
| Options | 02/27/2012 |
| Committee Recommendations | 03/20/2012 |
| Secretary's Final Decisions from March 15, 2012 | 04/24/2012 |
| January 19, 2012 | Last Modified |
|---|---|
| Agenda | 01/05/2012 |
| Options | 01/05/2012 |
| Cancelled due to lack of quorum | N/A |
| November 17, 2011 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| Agenda | 11/02/2011 |
| Options | 11/02/2011 |
| September 15, 2011 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| Agenda | 08/30/2011 |
| Options | 08/30/2011 |
| July 21, 2011 | Last Modified |
|---|---|
| Agenda | 07/06/2011 |
| Options | 07/06/2011 |
| Committee Recommendations | 07/25/2011 |
| Secretary's Final Decisions from July 21, 2011 | 08/26/2011 |
| May 19, 2011 | Last Modified |
|---|---|
| Agenda | 05/02/2011 |
| Options | 05/02/2011 |
| Committee Recommendations | 05/24/2011 |
| Secretary's Final Decisions from May 19, 2011 | 06/27/2011 |
| March 17, 2011 | Last Modified |
|---|---|
| Agenda | 02/28/2011 |
| Options | 02/28/2011 |
| Committee Recommendations | 03/23/2011 |
| Secretary's Final Decisions from March 17, 2011 | 04/26/2011 |
| January 20, 2011 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| Agenda | 01/05/2011 |
| Options | 01/05/2011 |
| November 18, 2010 | Last Modified |
|---|---|
| Agenda | 11/01/2010 |
| Options | 11/01/2010 |
| Committee Recommendations | 11/24/2010 |
| Secretary's Final Decisions from November 18, 2010 | 01/05/2011 |
| September 16, 2010 | Last Modified |
|---|---|
| Agenda | 09/01/2010 |
| Options | 09/01/2010 |
| Committee Recommendations | 09/22/2010 |
| Secretary's Final Decisions from September 16, 2010 | 10/28/2010 |
| Speaker Request Form | 09/01/2010 |
| July 15, 2010 | Last Modified |
|---|---|
| Cancelled due to lack of quorum | N/A |
| Agenda | 06/28/2010 |
| Options | 06/28/2010 |
| May 20, 2010 | Last Modified |
|---|---|
| Agenda | 05/05/2010 |
| Options | 05/05/2010 |
| Committee Recommendations | 05/27/2010 |
| Secretary's Final Decisions from May 20, 2010 | 06/28/2010 |
| Speaker Request Form | 05/05/2010 |
| March 18, 2010 | Last Modified |
|---|---|
| Agenda | 03/03/2010 |
| Options | 03/03/2010 |
| Committee Recommendations | 03/24/2010 |
| Secretary's Final Decisions from March 18, 2010 | 05/19/2010 |
| Speaker Request Form | 03/03/2010 |
Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Information
Magellan Medicaid Administration has provided a website to satisfy the CAQH Committee Operating Rules for Information Exchange (CORE) mandate requiring online capability for both Electronic Fund Transfer (EFT) and Electronic Remittance Advice (ERA) enrollment. Both forms can be completed and electronically submitted via the web portal at https://eftera.magellanrx.com.
Additionally, paper Electronic Fund Transfer (EFT) and Electronic Remittance Advice (ERA) enrollment forms have been revised in order to satisfy the CAQH Committee Operating Rules.
Electronic Funds Transfer (EFT)
To submit a request to receive an Electronic Funds Transfer (EFT) via the website go to https://eftera.magellanrx.com.
Electronic Funds Transfer (EFT) Help Document with Instructions
If you prefer to submit a paper request to receive an Electronic Funds Transfer (EFT) you can access the form and instructions here — EFT Paper Form (with Instructions & FAQ).
Note: If you would like to receive a paper check please contact Pharmacy Networks Services at 800-441-6001.
Electronic Remittance Advice (ERA)
To submit a request to receive an Electronic Remittance Advice (ERA) via the website go to https://eftera.magellanrx.com.
Electronic Remittance Advice (ERA) Help Document with Instructions
If you prefer to submit a paper form to receive an Electronic Remittance Advice (ERA) you can access the form and instructions here — ERA Paper Form (with Instructions & FAQ).
Note: If you would like to receive a paper Remittance Advice please contact Pharmacy Networks Services at 800-441-6001.
2013 Seminars
No seminars held in 2013.
2012 Seminars
No seminars held in 2012.
2011 Seminars
Seminar Information
Please refer to this link for the Spring 2011 seminar information. The RSVP regional letter, seminar directions, and presentation information are located on this website.
| Title | Last Modified |
|---|---|
| Pharmacy Spring 2011 Presentation | 03/28/2011 |
Seminar Schedule
| Region & Date | Location |
|---|---|
| Southeastern Kentucky - April 5, 2011 | Williamsburg Tourist and Convention Center 650 South 10th Street, Williamsburg, KY 40769 1:30 PM - 3:30 PM - Session C |
| Southeastern Kentucky - April 6, 2011 | Williamsburg Tourist and Convention Center 650 South 10th Street, Williamsburg, KY 40769 9:00 AM - 11:00 AM - Session E 1:30 PM - 3:30 PM - Session H |
| Southwestern Kentucky - April 14, 2011 | Kentucky Dam State Park Convention Center 113 Administration Drive, Gilbertsville, KY 42044 1:30 PM - 3:30 PM - Session C |
| Southwestern Kentucky - April 15, 2011 | Kentucky Dam State Park Convention Center 113 Administration Drive, Gilbertsville, KY 42044 9:00 AM - 11:00 AM - Session E 1:30 PM - 3:30 PM - Session H |
| Central Kentucky - April 19, 2011 | Four Points by Sheraton Lexington 1938 Stanton Way, Lexington, KY 40511 1:30 PM - 3:30 PM - Session C |
| Central Kentucky - April 20, 2011 | Four Points by Sheraton Lexington 1938 Stanton Way, Lexington, KY 40511 9:00 AM - 11:00 AM - Session E 1:30 PM - 3:30 PM - Session H |
| Southern Kentucky - April 27, 2011 | Holiday Inn University Plaza 1021 Wilkinson Trace, Bowling Green, KY 42103 1:30 PM - 3:30 PM - Session C |
| Southern Kentucky - April 28, 2011 | Holiday Inn University Plaza 1021 Wilkinson Trace, Bowling Green, KY 42103 9:00 AM - 11:00 AM - Session E 1:30 PM - 3:30 PM - Session H |
| Eastern Kentucky - May 4, 2011 | Jenny Wiley State Park Convention Center 75 Theatre Court, Prestonsburg, KY 41653 1:30 PM - 3:30 PM - Session C |
| Eastern Kentucky - May 5, 2011 | Jenny Wiley State Park Convention Center 75 Theatre Court, Prestonsburg, KY 41653 9:00 AM - 11:00 AM - Session E 1:30 PM - 3:30 PM - Session H |
| Western Kentucky - May 10, 2011 | Ramada Plaza 9700 Bluegrass Parkway, Louisville, KY 40299 1:30 PM - 3:30 PM - Session C |
| Western Kentucky - May 11, 2011 | Ramada Plaza 9700 Bluegrass Parkway, Louisville, KY 40299 9:00 AM - 11:00 AM - Session E 1:30 PM - 3:30 PM - Session H |
| Northern Kentucky - May 24, 2011 | Drawbridge Inn 2744 Royal Drive, Fort Mitchell, KY 41017 1:30 PM - 3:30 PM - Session C |
| Northern Kentucky - May 25, 2011 | Drawbridge Inn 2744 Royal Drive, Fort Mitchell, KY 41017 9:00 AM - 11:00 AM - Session E 1:30 PM - 3:30 PM - Session H |
2010 Seminars
Seminar Invite
| Title | Last Modified |
|---|---|
| Summer 2010 Pharmacy Seminar Invite | 07/30/2010 |
Seminar Registration
| Title | Last Modified |
|---|---|
| Summer 2010 Pharmacy Seminar Registration Form | 07/29/2010 |
Seminar Presentations
| Title | Last Modified |
|---|---|
| Summer 2010 Pharmacy Presentation | 02/02/2011 |
Seminar Schedule
| Region & Date | Location |
|---|---|
| Western Kentucky - August 27, 2010 | Murray State — Paducah Campus 3000 Irvin Cobb Dr, Room 112 Paducah, KY 42001 |
| Eastern Kentucky - August 31, 2010 | Jenny Wiley State Park Wilkinson Stumbo Convention Center 75 Theater Court, Cherokee Room Prestonsburg, KY 41653 |
| Central Kentucky - September 2, 2010 | Kentucky Transportation Cabinet Office Building Conference Center, Room 117 20 Mero Street Frankfort, KY 40622 |
| Southern Kentucky - September 8, 2010 | Cave City Convention Center 502 Mammoth Cave Street, West Hall A Cave City, KY 42127 |
| Northern Kentucky - September 14, 2010 | Boone County Library 7425 U.S. 42 Florence, KY 41042 |
For questions regarding the webinar(s) listed below please contact Michael Price at Mprice@Magellanhealth.com.
Presentations
| Title | Last Modified |
|---|---|
| Kentucky Medicaid Pharmacy 3Q2012 Webinar | 11/02/2012 |
| Kentucky Medicaid Pharmacy 1Q2011 Webinar | 03/30/2011 |