Pharmacy

Notices
Date Title
1/25/2023 Pharmacy Program Updates - January 2023
11/22/2022 Pharmacy Program Updates - November 2022
09/22/2022 Committee Recruitment letter 2022 w/ Application
09/16/2022 Pharmacy Program Updates - September 2022
09/19/2022 Medicaid Pharmacy Coastal Storms
07/19/2022 Billing Guidance for Paxlovid (TM) prescribed by enrolled Pharmacist Renderers Under EUA
04/20/2022 Pharmacy Program Updates - April 2022
02/02/2022 Pharmacy Program Updates - COVID-19 At-Home Test Pharmacy Billing Guidance - February 2022
01/25/2022 Pharmacy Program Updates - January 2022
11/23/2021 Pharmacy Program Updates – November 2021
10/19/2021 Pharmacy P&T/DUR Committee Meeting Notice and Agendas for November 19, 2021
09/24/2021 Pharmacy Program Updates – September 2021
09/02/2021 Pharmacy Program Updates: Diagnosis Code Required on Ivermectin Claims
08/19/2021 Pharmacy P&T/DUR Committee Meeting Notice and Agendas for September 17, 2021
04/21/2021 Pharmacy Program Updates – April 2021
01/26/2021 Pharmacy Program Updates – January 2021
11/23/2020 Pharmacy Program Updates – November 2020
09/22/2020 Pharmacy Program Updates – September 2020 Revised
09/22/2020 Pharmacy Program Updates – September 2020
09/02/2020Pharmacy Program Updates – Diagnosis Code Required on MAT-Related Drug Claims
09/02/2020Pharmacy Program Updates – Quantity Prescribed on Schedule II Claims
08/17/2020 Pharmacy Program Updates – August 2020
07/13/2020Medicaid Pharmacist Enrollment and Billing Training
06/09/2020Standing Order: Pharmacist Administration of COVID-19 Tests
05/13/2020Pharmacy Program Updates – May 2020
04/23/2020Pharmacy Program Updates – April 2020
04/01/2020Pharmacy Program Updates – COVID-19 Preparedness #3
03/26/2020Pharmacy Program Updates – COVID-19 Preparedness #2
03/20/2020Pharmacy Program Updates – COVID-19 Preparedness #1
03/05/2020Pharmacy Program Updates – COVID-19 and Early Refills
01/28/2020Pharmacy Program Updates – January 2020
11/25/2019Pharmacy Program Updates – November 2019
09/26/2019Pharmacy Program Updates – September 2019
08/30/2019Pharmacy Program Changes and Updates - SUPPORT Act
08/22/2019Medically Necessary Early Refills due to Wildfires
07/23/20192019 Cost of Dispensing Survey
07/09/2019Pharmacy Program Updates - 2019 July
05/02/2019Pharmacy Program Updates - 2019 May
04/16/2019Dsuvia and Spravato Conditions of Payment
01/31/2019 Alaska Medicaid Pharmacy Update - January 2019
12/07/2018 Alaska Medicaid Pharmacy Update - December 2018
10/09/2018 Alaska Medicaid Pharmacy Update - September 2018
09/10/2018 Pharmacy Program Updates - 2018 Fall
12/28/2017 Letter to Providers: Limit on Federal Financial Participation for Durable Medical Equipment in Medicaid
09/22/2017 Letter to Providers: HCV DAA PA Clinical Criteria for Use
09/22/2017 HCV DAA PA Clinical Criteria for Use - FINAL
09/01/2017 HCV DAA PA Clinical Criteria for Use (superseded by 09/22/2017 Final version)
03/31/2017 CMS-2345-FC Final Rule Effective April 1, 2017
03/24/2017 Opioid Claims ICD-10 Guidance for Pharmacies
03/21/2017 Alaska Medicaid Pharmacy Opioid Management Strategies and Initiatives
08/22/2016 Pharmacy Program Changes and Updates - August 2016
08/09/2016 Alaska Medicaid Pharmacy - Naloxone
07/27/2016 835 Electronic Remittance Advice Transmission Delay - Pharmacy Providers
07/05/2016 Drug Utilization Review Update - Direct Acting Antivirals
04/18/2016 New Federal Upper Limits for Multiple Source Drugs - Second Notice
04/01/2016 New Federal Upper Limits for Multiple Source Drugs
03/14/2016 Medicaid Policy Clarification: Cost of Gloves Used by Assisted Living Home Employees
06/29/2015 Pharmacy Program Changes and Updates - June 2015
04/29/2015 Pharmacy Program Changes and Updates - April 2015
02/17/2015 Pharmacy Preferred Drug List Update
02/02/2015 Pharmacy Program Changes and Updates - Winter 2015
01/29/2015 Pharmacy Program Update - Prior Authorization Pamphlet Regulations
12/23/2014 Pharmacy Program Changes and Updates - Fall 2014
07/24/2014 FDA Approved Covered Outpatient Drugs
05/07/2014 New State Maximum Allowable Cost - Effective 7/1/2014
04/22/2014 Regulation Changes: Outpatient Drugs and Pharmacy Claims
02/25/2014 Pharmacy Program Changes and Update – February 2014
12/17/2013 Pharmacy Program Changes and Update – December 2013
08/22/2013 Letter to Providers: Pharmacists and Prescribers Must be Enrolled in Alaska Medicaid to Prescribe for Medicaid Recipients
05/24/2013 Pharmacy Program Changes and Update – Summer 2013
05/09/2013 Pharmacy Program Changes and Update – May 2013
03/27/2013 Pharmacy Program Changes and Update – March 2013
01/24/2013 Pharmacy Program Changes and Update – Jan 2013
12/14/2012 Pharmacy Website Address Changes – Dec 2012
11/14/2012 Pharmacy Program Changes and Update - Nov 2012
10/01/2012 Atypical (2nd Generation) Antipsychotics - Clarification
06/11/2012 Brand Name Multisource Medication Claims and Atypical Antipsychotics Update - June 2012
05/15/2012 Pharmacy Program Changes and Update - May 2012
04/23/2012 Spring Update - 2012
02/21/2012 Pharmacy Program Changes and Update - Feb 2012  
02/16/2012 Pharmacy Program Changes and Update - Winter 2012  
02/10/2012 Opioid Theraputic Duplication Edits  
02/10/2012 Pharmacy Preferred Drug List Update  
01/10/2012 Myers and Stauffer Cost of Dispensing Survey Letter - Chain Pharmacy
01/10/2012 Myers and Stauffer Cost of Dispensing Survey Letter - Chain Pharmacy
01/10/2012 Myers and Stauffer Cost Dispensing Survey Letter - Independent Pharmacy
01/09/2012 Details Regarding NCPDP D.O Processing Changes for Pharmacy Claims: Update Letter
12/19/2011 Mediset Fee FAQ and Guidance Letter
12/13/2011 Details Regarding NCPDP D.O Processing Changes for Pharmacy Claims: Update Letter (revised 01/09/2012)
12/01/2011 Pharmacy Dispensing Fee Annual Prescription Volume Letter and Survey Form
11/21/2011 NCPDP D.0 Claims Processing: Update Letter
10/28/2011 Pharmacy Claims Reprocessing for Dispensing Fees - DOS: October 5, 2011 through October 21, 2011
09/26/2011 Pharmacy Coverage and Payment - New Prior Authorization and Quantity Limits
09/07/2011 Emergency regulations regarding reimbursement for Medisets: Effective 9/7/2011
08/31/2011 In-state pharmacy and dispensing prescriber payment regulation changes: Effective 9/7/2011
08/31/2011 Out of state pharmacy payment regulation changes: Effective 9/7/2011
08/01/2011 In-state pharmacy and dispensing prescriber payment regulation changes: Effective 9/7/2011 (revised 08/31/2011)
08/01/2011 Out of state pharmacy payment regulation changes: Effective 9/7/2011 (revised 08/31/2011)
07/22/2011 Opioid Quantity Limits Effective August 22, 2011
04/29/2011 Tobacco Cessation Medications and Counseling
04/15/2011 Prescribers must enroll with Alaska Medicaid
03/31/2011 Diabetic Durable Medical Equipment
11/03/2008 Pharmacy Updates 10-26-10
11/03/2008 NPI Compliance & the Prescriber Identifier
11/03/2008 NPI Required Effective October 31, 2007
11/03/2008 Alaska Medicaid Transition Period for Implementation of National Provider Identifier (NPI)
04/14/2008 Billing Requirements for Drugs Administered in Outpatient Clinical Settings
12/05/2005 Medicare Part D
10/28/2005 Pharmacy Cost Avoidance and Coordination of Benefits
09/13/2004 Implementation of NCPDP Partial Fills Functionality
06/11/2004 Preferred Drug List
12/09/2003 Implementation of NCPDP Version 5.1 Compound Segment
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Prescription Drug Lookup Tool

Alaska Medicaid Drug Lookup is a new tool provided by the Division of Health Care Services, through Magellan Rx Management, to assist Medicaid providers with general coverage status of drugs. Visit Alaska Medicaid Drug Lookup for more information or Drug Lookup to begin a search. Final coverage determinations are made during claims adjudication; Drug Lookup does not provide cost limit, authorization, or service limit information.


Regulation Scoping Materials

Title
Regulation Scoping Meeting slides, 2021 May 24
2020 Alaska Medicaid Cost of Dispensing Survey - Final Report

Magellan Rx ManagementSM Publications

Title
Magellan Pharmacy Trend Report
Magellan Rx Report
Medicaid Trend Report
MRx Clinical Alerts

Forms

Title Last Modified
Alaska Medicaid NADAC Price Review Request Form 11/03/2022
Botulinum Toxin Prior Authorization Request Form 09/01/2022
Clinical Coverage Conflict of Interest Disclosure Form 08/18/2022
General Medication Prior Authorization Request Form 08/18/2022
MAT Provider Standards of Care Attestation 08/18/2022
Pharmaceutical Manufacture Submission Form 08/17/2021
Prescription Drug Benefits, Prior Authorization, and Fair Hearing Pamphlet for Recipients 01/25/2021
Recipient Subtype Eligibility Inquiry Form 01/03/2017
Synagis Prior Authorization Criteria 2022-2023 08/31/2022
Synagis Prior Authorization Request Form 2022-2023 08/31/2022
More State of Alaska Health Care Services Pharmacy Medication Prior Authorization Forms  

Documents

Title Last Modified
Alaska Medicaid D.0 Payer Specification 02/18/2021
2012 Alaska Medicaid Cost of Dispensing Survey - Final Report 08/17/2012
Current Pharmacy Carrier List
Preferred Drug List - Alaska Division of Health Care Services Web site
New Prior Authorization Clinical Criteria

Helpful Links

Title
Medicaid Drug Rebate Program
CMS Pharmacist Center
CMS Federal Upper Limits
CMS Pharmacy Pricing