Provider Advisories



​​Medicaid Corona​virus Disease 2019 (COVID-19) Updates​
During this rapid​ly evolving situation, we will provide updates as they become available. All Medicaid Providers should check the Medicaid COVID-19 Provider Updates page often for updates. For general coronavirus information, visit coronavirus.maryland.gov​​​.​ 

 
​2021 ​ ​ ​
Date Nu​mber Subject Targeted Provider
​September 1
 231
​Pharmacy Provider Guidance on COVID-19 Additional Vaccine ​​Dose
​Pharmacists and Pharmacies
August 4
230
​Resumption of COVID-19 Emergency Activity Prior Authorization Requirements
Pharmacists and Pharmacies
July 12​
229 MDH Office of Pharmacy Services Call Center Helpline Return to Live Call OperationsPharmacists and Pharmacies
June 23228
Elimination of S​ignature-less Deliveries of PharmaceuticalsPharmacists and Pharmacies
June 18227
Maryland's Preferred Drug List effective 7-1-21Pharmacists, Physicians and Pharmacies
April 21226 Changes to DAW6 Drug ProgramPharmacists and Pharmacies
April 20225 Opioid Naive ParticipantsPharmacists and Pharmacies
March 23224 COVID-19 Vaccine Incentive Fee Increase - UPDATEPharmacists and Pharmacies
January 29223 Nutritional SupplementsPharmacists and Pharmacies
January 27222 Updated Professional Dispensing feesPharmacists and Pharmacies
January 12221 Updated Pharmacy Provider GuidancePharmacists and Pharmacies
  ​ ​ ​
2020 ​ ​ ​
Date Number Subject Targeted Provider
December 18220 Maryland's Preferred Drug List effective 1-1-2021Pharmacists, Pharmacies and Physicians
December 11219 Pharmacy Provider Guidance on COVID-19 Vaccines AdministrationPharmacists and Pharmacies
November 17218 Brand Bethkis is Preferred on PDL.Pharmacists and Pharmacies
October 20217 Pharmacy Provider Guidance on VaccinesPharmacists and Pharmacies
September 22216 Quantity Prescribed Field Required for Schedule II DrugsPharmacists, Pharmacies and Physicians
August 10215 Testing for COVID-19 by Medicaid Pharmacies - Follow-up Guidance (updated)Pharmacists and Pharmacies
June 17214 Maryland's Preferred Drug List 7-1-20Pharmacists, Pharmacies and Physicians
June 10213 Testing for COVID-19 by Medicaid Pharmacies - Follow-up GuidancePharmacists and Pharmacies
May 29212 Testing for COVID-19 by Medicaid PharmaciesPharmacists and Pharmacies
April 22211 MDH Office of Pharmacy Services Call Center Helpline Changes to Voicemail SystemPharmacists, Pharmacies, Physicians and Consumers
April 7210 14-day supply emergency overridePharmacists and Pharmacies
April 3209 Signature-less Deliveries of Pharmaceuticals - Follow-up GuidancePharmacists and Pharmacies
April 1208 Signature-less Deliveries of PharmaceuticalsPharmacists and Pharmacies
March 27207 14-day emergency supplyPharmacists and Pharmacies
March 12206 Waiving Early Refill EditsPharmacists, Pharmacies and Physicians
February 13205 Removal of Adderall XR from DAW6Pharmacists and Pharmacies
 ​ ​ ​ ​
2019 ​ ​ ​
Date Number Subject Targeted Provider
December 13204 Preferred Drug List 1.1.2020Pharmacists, Pharmacies and Physicians
December 10203 Lyrica Capsules Removal from DAW6Pharmacists and Pharmacies
December 5202 Carve-In of HIV-AIDS Medications to MCOPharmacists, Pharmacies and Providers
November 14201 Hepatitis C CE SeminarProviders and Pharmacists
October 23200 Lyrica Oral solution Removal from DAW6Pharmacists and Pharmacies
July 26199 RevatioPharmacists and Pharmacies
July 26198 Brand Lyrica is PreferredPharmacists and Pharmacies
June 19197 Maryland's Preferred Drug ListPharmacists, Pharmacies and Physicians
April 5196 Brand vs Generic DAW 6 changesPharmacists and Pharmacies
March 4195 Suboxone Film now preferredPharmacists and Pharmacies
February 14194 Brand vs Generic DAW 6 changesPharmacists and Pharmacies
January 24193 Kapvay ER Removal from DAW6. 1.28.19Pharmacists and Pharmacies
January 23192 Reyataz Removal from DAW6. 2.15.19Pharmacists and Pharmacies
  ​ ​ ​
2018 ​ ​ ​
Date Number Subject Targeted Provider
December 19191 PDL Maryland's Preferred Drug ListPharmacies, Pharmacists and Physicians
December 12190 Carve Out of Spinraza and CinryzePharmacies and Pharmacists
October 3189 Diastat Removal from DAW 6 ProgramPharmacies, Pharmacists and Physicians
September 20188 Carve Out of LucemyraPharmacies and Pharmacists
August 3187 Long Term Care Eligibility for Medicaid RecipientsPharmacies and Pharmacists
June 29186 DAW6 Suboxone FilmPharmacies and Pharmacists
June 27185 Preferred Drug List 7.1.18Pharmacists, Pharmacies and Consumers
April 24184 Removal of Brand InvegaPharmacists and Pharmacies
April 17183 Norvir and ReyatazPharmacists and Pharmacies
April 16182 Changes DAW6Pharmacists and Pharmacies
February 13181 Tamiflu and it's generic Change on the PDLPharmacists and Pharmacies
February 2180 Change in Online Preferred drug ListPharmacists, Pharmacies and Consumers
  ​ ​ ​
​2017 ​ ​ ​
Date Number Subject Targeted Provider
December 20179 Preferred Drug List 1.1.18Pharmacists, Pharmacies and Consumers
December 13178 Sabril Powder PacketPharmacy, Pharmacists and Physicians
December 5177
Carve-out of IngrezzaPharmacy, Pharmacists and Physicians
June 22176 Maryland Preferred Drug List 7. 1 .17Pharmacists, Pharmacies and Consumers
June 16
175 Changes in the Opiate ClassPharmacists , Pharmacies and Consumers
May 12174 Brand Metadate CD Removal from DAW 6 ProgramPharmacists and Pharmacies
April 5173 FSS and Nominal Price UpdatePharmacists and Pharmacies
March 30172 Change in Pharmacy Reimbursement MethodologyPharmacists and Pharmacies
March 29171 (correction) Removal of Brand Seroquel XR DAW6Pharmacists and Pharmacies
March 13171 Removal of Brand Seroquel XR DAW6Pharmacists and Pharmacies
  ​ ​ ​
2016 ​ ​ ​
Date Number  Subject Targeted Provider
December 21170 Maryland's Preferred Drug List 1 1 17Pharmacists, Pharmacies and Consumers
November 18169 Seroquel XR DAW6Pharmacists and Pharmacies
October 26168 Generic vs Brand ChangesPharmacists and Pharmacies
October 19167 Copay for Tobacco Cessation ProductsPharmacists, Pharmacies and Consumers
June 14166 PDL as of 7/ 1/ 16Pharmacists, Pharmacies and Consumers
June 1165 Zubsolv Preferred 6.1.16Pharmacists and Pharmacies
May 3164 Gleevac® (Brand) tablets Is to Be Dispensed Over Its GenericPharmacists and Pharmacies
April 26163 Nasonex® Nasal Spray 50 mcg Is Preferred (DAW6) Over Its GenericPharmacists and Pharmacies
March 3162 Advisory 162 BrandsPharmacists and Pharmacies
  ​ ​ ​
​2015 ​ ​ ​
Date Number Subject Targeted Provider
December 17161 PDL as of 1/1/2016Pharmacists, Pharmacies and Consumers
December 1160 Brand AbilifyPharmacists and Pharmacies
November 20159 Invega Tablets on DAW 6 ProgramPharmacists and Pharmacies
September 30158 Clozapine update_ REMSPharmacists and Pharmacies
July 9157 Copaxone 20mg DAW6. Pharmacists and Pharmacies
June 22156 PDL as of 7/1/2015Pharmacists, Pharmacies and Consumers
May 12155 Generic vs BrandPharmacists and Pharmacies
March 13154 Quantity LimitsPharmacists, Pharmacies, Physicians and Consumers
  ​ ​ ​
2014 ​ ​ ​
Date Number Subject Targeted Provider
December 19153 PDL as of 1/1/2015
Pharmacists, Pharmacies and Consumers
December 11152 Intuniv DAW 6Pharmacists, Pharmacies, Physicians and Consumers
December 11151 Carve Out of Substance Use Disorder Medications and SuboxonePrescribers
December 5150 Carve-Out of Substance Use Disorder MedicationsPharmacists and Pharmacies
October 10149 How to prescribe NaloxonePrescribers
September 12148 Carve-Out of NaloxonePharmacists and Pharmacies
July 30147 Tramadol as a Controlled SubstancePharmacists, Physicians and Pharmacies
July 9146 Changes in DAW 6 programPharmacists, Physicians and Pharmacies
June 17145 PDL as of 07/01/14Pharmacists, Physicians and Consumers
June 10144 Quantity LimitsPharmacists, Pharmacies, Physicians and Consumers
April 23143 Autorefill and return to stockPharmacists and Pharmacies
April 11142 QL UpdatePharmacists, Physicians and Consumers
  ​ ​ ​
2013 ​ ​ ​
DateNumberSubjectTargeted Provider
December 26141 MD PDLPharmacists, Physicians and Consumers
December 19140 CymbaltaPharmacists and Pharmacies
December 5139 OTC Plan B no age limitPharmacists and Pharmacies
October 25138 Update on MADAP ProgramPharmacists and Pharmacies
October 24137 Extended OutagePharmacists and Pharmacies
October 15136 PAC programPharmacists and Pharmacies
October 9135 Brand name LidodermPharmacists and Pharmacies
July 24134 Peer Review Program Expansion 0 to 17Pharmacists, Pharmacies and Physicians
July 12133 Some Brands Preferred over generics July 2013Pharmacists, Pharmacies and Physicians
July 1132 MD PDL 7.1.13Pharmacists, Physicians and Consumers
May 29131 Some Brands Preferred over generics June 2013Pharmacists and Pharmacies
April 1130 72 hours emergency supplyPharmacists and Pharmacies
January 8129 Openings on P&T CommitteePharmacists, Physicians and Consumers
 ​ ​ ​ ​
2012 ​ ​ ​
Date Number Subjects Targeted Provider
December 28128 Preferred Drug List UpdatePharmacies
December 20127 Drug Coverage Changes for Full DualsPharmacies
December 17126 Update on New Operating System for MMPPPharmacies
December 11125 Holiday Payment SchedulePharmacies
November 27124 Metadate CD Becomes a Preferred Brand in MedicaidPharmacies
November 7123 Some Brands Preferred over generics Nov. 2012Pharmacies
November 7122 No PA Required for Tier 2 Abilify for ages 10-17Prescribers
October 11121 Ovide Will No Longer Be Brand PreferredPharmacies
October 4120 New Operating System for MMPPPharmacies
September 19119 Geodon Will No Longer Be Brand preferredPharmacies
September 18118 Lexapro Will No Longer Be Brand PreferredPharmacies
September 14117 Prior Authorization for Tier 2 and Non-preferred Antipsychotic DrugsPharmacies and Prescribers
August 7116 New Web Address for Pharmacy ProgramPharmacies and Prescribers
July 20115 Peer Review Programs Expanded to Include Children up to Age 10
Pharmacies and Prescribers
July 3114 Changes in Preferred Brands vs Generics: Kadian and RoxicodonePharmacies
June 27113 Preferred Drug List July 1, 2012Prescribers and Pharmacies
June 8112 Updates to List of Brand Drugs Preferred vs Generics on the Maryland Medicaid PreferredPharmacies and Prescribers
May 30111 Lipitor No Longer Brand Preferred on Maryland Medicaid Preferred Drug ListPrescribers and Pharmacies
April 25110 Medicaid Prefers Brands Lexapro and GeodonPharmacies and Prescribers
February 3109 Medicaid Temporarily Authorizes Brand Prevacid SolutabsPrescribers and Pharmacies
January 4108 Late Refills for HIV Drugs - AgainPharmacies
  ​ ​ ​
2011 ​ ​ ​
Date Number Subjects Targeted Provider
December 29107 Preferred Drug List UpdatePharmacies and Prescribers
December 29106 Cost of Dispensing AnalysisPharmacies
December 21105 Holiday Payment SchedulePharmacies
December 20104 Transition to D.0Pharmacies
December 20103 Transition to D.0 for LTC PharmaciesPharmacies
December 13102 Changes in Preferred Multisource Brands on PDL, Use DAW 6Prescribers and Pharmacies
December 5101 Clarify Regulation ChangesPharmacies
November 30100 Pharmacy Services Regulation ChangesPharmacies
November 499 Late Refills for HIV/AIDS MedicationsPharmacies and Prescribers
October 798 Peer Review Program for AntipsychoticsPharmacies and Prescribers
June 3097 Preferred Drug List Updat​e
Pharmacies and Prescribers
June 2996 Dispensing Fee Changes
All Pharmacies
June 2895 Preferred Brands on the PDL, Use DAW 6Pharmacies and Prescribers
June 2794 Corrective Managed Care Programs and Misuse of Controlled SubstancesPharmacies
June 2393 Quantity Limits and Dose OptimizationPhysicians and Pharmacies
May 1392 OIG AuditsPharmacies
May 1391 List of Preferred Multisource Brands Has ChangedPrescribers and Pharmacies
April 2990 Notice of Survey for Dispensing FeePharmacies
March 2389 Kapvay for Ages 6-17 Moved to Mental Health Carve-OutPharmacies and Prescribers
February 2588 Important Changes Related to Prior Authorization Requests for Fee-for-Service MembersPharmacies and Prescribers
  ​ ​ ​
​2010 ​ ​ ​
Date Number Subjects Targeted Provider
September 3087 Generic vs Brand on the Preferred Drug ListPrescribers and Pharmacies
September 3086 Updated Preferred Drug List Effective October 1, 2010Prescribers and Pharmacies
July 1985 Reminder: Tamper Resistant Prescriptions Required for Medicaid RxPrescribers and Pharmacies
June 2884 Intuniv Moved to Mental Health Formulary for MCO Members Aged 6-17 Effective July 1, 2010Prescribers and Pharmacies
April 1683 Limited Coverage of OTC Drugs for Dual EligiblesPrescribers and Pharmacies
April 182 Few Exceptions to Generic SubstitutionPrescribers and Pharmacies
March 3181 Preferred Drug List Effective April 1, 2010Prescribers and Pharmacies
March 1380 Over the Counter Plan B CoveragePharmacies
February 979 Rubber Stamped Prescribed Are InvalidPrescribers and Pharmacies
January 2678 Effective handling of Claim RejectionsPharmacies
  ​ ​ ​
​2009 ​ ​ ​
Date Number Subjects Targeted Provider
December 1877 Holiday ClosingsPharmacies and Prescribers
October 976 Update on mass Adjustments of legend InsulinsPharmacies
October 175 Over-the-Counter Plan B Coverage Up-DatePharmacies
October 274 Some Multisource Brand Name Drugs Preferred Over GenericsPharmacies and Prescribers
October 173 Preferred Drug List Effective October 1, 2009Pharmacies and Prescribers
October 172 Changes for the Status of Antipsychotic Medication on Preferred Drug ListPrescribers
September 3071 30-Day Emergency Supply of Atypical AntipsychoticsPharmacies
September 2470 Mass Adjustment for Legend InsulinsPharmacies
June 2969 Changes in Mental Health Carve OutPharmacies and Prescribers
May 1968 New Denial Codes for Non-rebatable Drugs, DESI and Obsolete DrugsPharmacies
April 2267 Not all Generics are PreferredPharmacies and Prescribers
April 966 Preferred Drug List Effective April 1, 2009Pharmacies and Providers
April 765 Maryland Medicaid May Cover up to a 30-day Emergency Supply of Atypical AntipsychoticsPharmacies
March 2464 Time Limit Extended for Filing ClaimsPharmacies
February 1863 Prescriber NPI Required on Pharmacy Claims, Effective March 1, 2009Prescribers
February 1862 Claim Must Have Prescriber NPIPharmacies
  ​ ​ ​
2008 ​ ​ ​
Date Number Subjects Targeted Provider
December 2261 Pharmacy Hotline Holiday SchedulePharmacies
December 960 Depo-medroxyprogesteronePharmacies
December 1859 Payments Delayed One WeekPharmacies
September 2458 30-day Emergency Supply May be Available for Atypical Antipsychotic PrescriptionsPharmacies
September 2257 Required Tamper-resistant Pad Features Effective October 1, 2008Pharmacies
September 2256 Required Tamper-resistant Prescription Pad Features Effective October 1, 2008Prescribers
September 1855 Automatic Correction of Underpayments for CellCept, Lunesta, Xopenex, Fuseon kit and Travatan Z ClaimsPharmacies
September 1254 Scheduled Down Time for Medicaid Claims Processing SystemPharmacies
August 2053 Physician Administered MedicationsPrescribers
July 1652 Intervention CodesPharmacies
July 1551 Pain Management AgreementsPrescribers
June 2550 Information about Formularies, PDL and PAs at Epocrates.com and DHMH websitePrescribers and Pharmacies
May 249 Prescriber NPIPharmacies
April 1148 POS System MaintenancePharmacies
April 347 Preferred Drug List, effective April 1, 2008Prescribers and Pharmacies
March 2646 NPI Information for PrescribersPrescribers and Pharmacies
March 745 Tamper Resistant Prescription Pad Features to be Phased in Beginning April 1, 2008Prescribers and all Pharmacies
February 2644 Reminder: At Least One Recognized Tamper Resistant Feature Required as of April 1, 2008 on all Written Medical PrescriptionsPrescribers and all Pharmacies
February 1243 Temporary Technical Difficulty Processing Medstar Family Choice ClaimsAll Pharmacies
February 642 March 1- NPI Required on ClaimsProviders
 ​ ​ ​ ​
2007 ​ ​ ​
Date Number Subjects Targeted Provider
December 2741 Atypical Antipsychotics, Zyprexa Step Therapy, AIDS/HIV Drugs Carved Out from MCOs, Refills of Controlled DrugsProviders and Prescribers
October 140 Tamper-Resistant Prescription Pads Are Delayed Until April 1, 2008Prescribers and all Pharmacies
August 2939 Changes to Preferred Drug ListPrescribers and all Pharmacies
May 938 Correction of Underpayments, Over-the-Counter Plan B Coverage, Clinical Criteria for Cymbalta, Coordination of BenefitsPrescribers and all Pharmacies
April 1237 Possible Underpayments, Unacceptable Prescriber DEA Numbers, Early Refills for Recently Discharged Long Term CarePrescribers and all Pharmacies
March 2836 Explanations of Some Claim Rejection Messages, New EVS Inquiry Phone Number, NPI Reminder, and Changes to Preferred Drug List (PDL) effective April 2007All Pharmacies
February 935 Late PaymentsAll Pharmacies
February 534 New Medicaid POS Claims ProcessorAll Pharmacies
January 2433 POS System To Be Shutdown: New Fax Numbers for PAsAll Pharmacies
January 1732 Reminder - POS Provider TrainingAll Pharmacies
  ​ ​ ​
2006
Date Number Subjects Targeted Provider
December 2131 New POS Processor; Zocor®; Prescription Transfers; Part D QuestionsAll Pharmacies
October 530 Pharmacy Dispensing Fee SurveyAll Pharmacies
September 2729 Changes to the Preferred Drug List; New EVS System; Narrow Therapeutic Index DrugsPrescribers and all Pharmacies
July 2828 Brand Name PDL Anomalies Useful Medicare Part D Phone NumbersPrescribers and all Pharmacies
June 2927 New Primary Adult CarePrescribers and all Pharmacies
May 1126 New Primary Adult Care Program (PAC) Medicare Part D Exception and Prior Authorization Request FormPrescribers and all Pharmacies
March 2325 Revised Preferred Drug List Transition from Pharmacy Assistance to Medicare Part DPrescribers and All Pharmacies
March 224 Dummy DEA Numbers Medicare Pare D IssuesAll Pharmacies
February 2223 Changes to the Preferred Drug List (PDL) Effective April 2006Prescribers and all Pharmacies
January 1022 Useful Medicare Phone Numbers & Medicaid Coverage of Drug Classes Excluded from Medicare Part D Basic PlansAll Pharmacies
  ​ ​ ​
2005 ​ ​ ​
Date Number Subjects Targeted Provider
December 1621A Temporary Suspension of Early Refill Edits for Medicare RecipientsPrescribers
December 1421 Temporary Suspension of Early Refill Edits for Medicare RecipientsAll Pharmacies
November 2320 Medicare Part DPrescribers and all Pharmacies
September 1619 Changes to the Preferred Drug List (PDL) Step Therapy for Stimulants and Related Agents Revised Quantity Limits for EmendPrescribers and all Pharmacies
September 1218 Hurricane Katrina Evacuees and Maryland Medicaid ProgramPrescribers and all Pharmacies
June 23 (Revised June 28)17 Revised Preferred Drug List
Special Grandfathering for Norvasc, Coreg and Zetia
Safety Concerns for Certain Generics
Antimigraine (Triptan) Quantity Limits
Prescribers and all Pharmacies
April 2816 Claims Processing Upgrade NotesAll Pharmacies
April 1315 Planned Claims Processing System MaintenanceAll Pharmacies
March 114
Further Clarification: Atypical Antipsychotic Dose Optimization Appropriate Use of Palladone Grandfathering Non-Preferred Mental Health DrugsPrescribers and all Pharmacies
  ​ ​ ​
2004 ​ ​ ​
  ​ ​ ​
​2003 ​ ​ ​
Date Number Subjects Targeted Provider
December 124 Revised Preferred Drug List (PDL): Cumulative Update for PrescribersPrescribers
N​ovember 33 Preferred Drug List (PDL Implementation) PDL Instructions for the PrescriberPrescribers
October 312 Preferred Drug List (PDL Implementation) PDL Instructions for the PharmacistCommunity Pharmacies
October 91 Change in Pharmacy Assistance Co-payCommunity Pharmacies

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