Provider Advisories


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​Medicaid Coronavirus 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​Number​Subject​Targeted Provider
​April 21​226Changes to DAW6 Drug Program​Pharmacists and Pharmacies
​April 20​225 Opioid Naive Participants​Pharmacists and Pharmacies
​March 23​224 COVID-19 Vaccine Incentive Fee Increase - UPDATE​Pharmacists and Pharmacies
​January 29​223Nutritional Supplements​Pharmacists and Pharmacies
January 27​222Updated Professional Dispensing fees​Pharmacists and Pharmacies
​January 12​221 Updated Pharmacy Provider Guidance​Pharmacists and Pharmacies
  
​ 

2020

​​Date​Number​Subject​Targeted Provider
​December 18​220Maryland's Preferred Drug List effective 1-1-2021​Pharmacists ,Pharmacies and Physicians
​December 11​219Pharmacy Provider Guidance on COVID-19 Vaccines Administration​Pharmacists and Pharmacies
​November 17​218Brand Bethkis is Preferred on PDL.​Pharmacists and Pharmacies
​October 20​217 Pharmacy Provider Guidance on Vaccines​Pharmacists and Pharmacies
​September 22​216 Quantity Prescribed Field Required for Schedule II Drugs​Pharmacists,Pharmacies and Physicians
​August 10​215Testing for COVID-19 by Medicaid Pharmacies - Follow-up Guidance (updated)​Pharmacists and Pharmacies
​June 17​214Maryland's Preferred Drug List 7-1-20​Pharmacists, Pharmacies and Physicians
​June 10​213 Testing for COVID-19 by Medicaid Pharmacies - Follow-up Guidance docx​Pharmacists and Pharmacies
​May 29​212 Testing for COVID-19 by Medicaid Pharmacies​Pharmacists and Pharmacies
​April 22​211MDH Office of Pharmacy Services Call Center Helpline Changes to Voicemail System​Pharmacists, Pharmacies, Physicians and Consumers
​April 7​21014-day supply emergency override​Pharmacists and Pharmacies
​April 3​209Signature-less Deliveries of Pharmaceuticals - Follow-up Guidance​Pharmacists and Pharmacies
April 1​208Signature-less Deliveries of PharmaceuticalsPharmacists and Pharmacies​
​March 27​20714-day emergency supply​Pharmacists and Pharmacies
​March 12​206 Waiving Early Refill Edits​Pharmacists, Pharmacies and Physicians
​February 13​205 Removal of Adderall XR from Daw6​Pharmacists and Pharmacies

 

2019

​Date
​Number​Subject​Targeted Provider
​December 13​204Preferred Drug List 1.1.2020​Pharmacists, Pharmacies and Physicians
​December 10​203Lyrica Capsules Removal from DAW6​Pharmacists and Pharmacies
​December 5​202 Carve-In of HIV-AIDS Medications to MCO​Pharmacists, Pharmacies and Providers
​November 14​201 Hepatitis C CE Seminar​Providers and Pharmacists
​October 23​200Lyrica Oral solution Removal from DAW6

​Pharmacists and

 Pharmacies 

​July 26​199 Revatio​Pharmacists and Pharmacies
​July 26​198 Brand Lyrica is Preferred​Pharmacists and Pharmacies
​June 19​197 Maryland's Preferred Drug List​Pharmacists and Pharmacies and Physicians
​April 5​196Brand vs Generic DAW 6 changes ​Pharmacists and Pharmacies
​March 4​195 Suboxone Film now preferred​Pharmacists and Pharmacies
​February 14​194 Brand vs Generic DAW 6 changes​Pharmacists and Pharmacies
​January 24​193 Kapvay ER Removal from DAW6. 1.28.19​Pharmacists and Pharmacies
​January 23​192 Reyataz Removal from DAW6. 2.15.19​Pharmacists and Pharmacies
 

2018

​Date​Number​Subject​Targeted Provider
​December 19​191 PDL Maryland's Preferred Drug List​Pharmacies and Pharmacists and Physicians
​December 12​190 Carve Out of Spinraza and Cinryze​Pharmacies and Pharmacists
​October 3​189 Diastat Removal from DAW 6 Program​Pharmacies, Pharmacists and Physicians
​September 20​188Carve Out of Lucemyra​Pharmacies and Pharmacists
​August 3​187Long Term Care Eligibility for Medicaid Recipients​Pharmacies and Pharmacists
​June 29​186 DAW6 Suboxone Film​Pharmacies and Pharmacists
​June 27​185 Preferred Drug List 7.1.18​Pharmacists and Pharmacies and consumers
​April 24​184 Removal of Brand Invega​Pharmacists and Pharmacies
​April 17​183Norvir and Reyataz​Pharmacists and Pharmacies
​April 16​182 Changes DAW6 ​Pharmacists and Pharmacies
​February 13181 Tamiflu and it's generic Change on the PDL
Pharmacists and Pharmacies
​February 2​​180
 Change in Online Preferred drug List
​Pharmacists, Pharmacies and consumers

2017

​Date​Number​Subject​Targeted Provider
​December 20​179Preferred Drug List  1.1.18. ​Pharmacists, Pharmacies and consumers
​December 13​178Sabril Powder Packet​Pharmacy, Pharmacists and Physicians
​December 5​177Carve-out of Ingrezza​Pharmacy, Pharmacists and Physicians
​June 22​176​ Maryland Preferred Drug List 7. 1 .17.​Pharmacists,Pharmacies and Consumers
​June 16​175Changes in the Opiate Class.​Pharmacists , Pharmacies and Consumers
​May 12​174Brand Metadate CD Removal from DAW 6 Program​Pharmacists and Pharmacies
​April 5​173 FSS and Nominal Price Update ​Pharmacists and Pharmacies
​March 30​172Change in Pharmacy Reimbursement Methodology​Pharmacists and Pharmarcies
​March 29​171(correction) Removal of Brand Seroquel XR DAW6​Pharmacists and Pharmacies
​March 13171 Removal of Brand Seroquel XR DAW6 ​Pharmacists and Pharmacies
 

2016

​DateNumber​​                Subject​Targeted Provider
​December 21170​​  Maryland's Preferred Drug List 1 1 17​Pharmacists, Pharmacies and Consumers
​November 181​69​  Seroquel XR DAW6​Pharmacists and Pharmacies
​October 26168​​  Generic vs Brand Changes​Pharmacists and Pharmacies
​October 19167​​ Copay for Tobacco Cessation Products​Pharmacists, Pharmacies and Consumers
​June 14166​   PDL as of 7/ 1/ 16​Pharmacists, Pharmacies and Consumers
​June 1 165​ Zubsolv Preferred 6.1.16​Pharmacists and Pharmacies
​May 3 164​​ Gleevac® (Brand) tablets Is to Be Dispensed Over Its Generic ​Pharmacists and Pharmacies
​April 26 163​ Nasonex® Nasal Spray 50 mcg Is Preferred (DAW6) Over Its Generic .​Pharmacists and Pharmacies
March 3​​162 Advisory 162 Brands​Pharmacists and Pharmacies


2015  

​DateNumber​​                Subject​Targeted Provider
​December 17​161  PDL as of 1/1/2016 ​Pharmacists,  Pharmacies and Consumers
December 1​​160  Brand Abilify​Pharmacists and Pharmacies
November 20​​159Invega Tablets on DAW 6 Program​Pharmacists and Pharmacies
September 30​ ​158 Clozapine update_ REMS​Pharmacists and Pharmacies
July 9​ 157​  Copaxone 20mg DAW6. ​Pharmacists and Pharmacies
June 22​ 156​ PDL as of 7/1/2015 ​Pharmacists and Pharmacies and Consumers
May 12​​ ​155​  Generic vs Brand​Pharmacists and Pharmacies
March 13​ ​154Quantity Limits ​Pharmacists, Pharmacies​, Physicians and Consumers
 

 2014

​Date Number​ Subject​ Targeted Provider​
December 19​ 153​  PDL as of 1/1/2015.pdfPharmacists and Pharmacies and Consumers​
December 11152​ Intuniv DAW 6 .pdfPharmacists, Pharmacies, Physicians and Consumers​
December 11​151​  Carve Out of Substance Use Disorder Medications and Suboxone.pdfPrescribers​
December 5​150​  Carve-Out of Substance Use Disorder Medications.pdfPharmacists and Pharmacies
October 10​149​  How to prescribe Naloxone.pdfPrescribers
September12​148​  CARVE-OUT OF NALOXONE .pdfPharmacists and Pharmacies​
July 30​​147  Tramadol as a Controlled Substance.pdfPharmacists and Physicians and Pharmacies​
July 9​​146Changes in DAW 6 program.pdfPharmacists and Physicians and Pharmacies​
June 17​​145  PDL as of 07/01/14.pdfPharmacists and Physicians and Consumers​
June 10​144  Quantity Limits.pdfPharmacists , Pharmacies​,Physicians and Consumers
April 23​143​  Autorefill and return to stock.pdfPharmacists and Pharmacies​
April 11​142​  QL Update.pdfPharmacists and Physicians and Consumers​

2013​

Date​Number​Subjects​ Targeted Provider
December 26​​141 MD_PDL.pdfPharmacists and Physicians and Consumers​
December 19​140​ Cymbalta.pdfPharmacists and Pharmacies​
December 5​139​ OTC Plan B no age limit .pdfPharmacists and Pharmacies​
October 25​138​ Update on MADAP Program .pdfPharmacists and Pharmacies​
October 24​137​ Extended Outage .pdfPharmacists and Pharmacies​
October 15​136​ PAC program .pdfPharmacists and Pharmacies​
October 9​​135 Brand name Lidoderm.pdfPharmacists and Pharmacies​
July 24​​134 Peer Review Program Expansion 0 to 17.pdfPharmacists and Pharmacies and Physicians​
July 12​133​ Some Brands Preferred over generics July 2013 Pharmacists and Pharmacies and Physicians​
July 1​132​ MD_PDL 7.1.13. Pharmacists and Physicians and Consumers​
May 29​131​ Some Brands Preferred over generics June 2013Pharmacists and Pharmacies​
April 1 130 72 hours emergency supply Pharmacists and Pharmacies
January 8​129​ Openings on P&T Committee Pharmacists and Physicians and Consumers​​

2012

Date

Number

Subjects

Targeted Provider

December 28​​128 Preferred Drug List Update Pharmacies​
December 20​127​ Drug Coverage Changes for Full Duals Pharmacies​
December 17​126​ Update on New Operating System for MMPP Pharmacies​
December 11​​125holiday payment schedulePharmacies​
November 27​​124Metadate CD Becomes a Preferred Brand in MedicaidPharmacies​
November 7​​123Some Brands Preferred over generics Nov. 2012​Pharmaices
November 7​​122No PA Required for Tier 2 Abilify for ages 10-17​Prescribers
October 11​​121Ovide Will No Longer Be Brand Preferred.pdfPharmacies​
October 4​​120New Operating System for MMPP​Pharmacies
September 19​​119Geodon Will No Longer Be Brand preferredPharmacies​
September 18​118​Lexapro Will No Longer Be Brand Preferred​Pharmacies
September 14​​117​Prior Authorization for Tier 2 and Non-preferred Antipsychotic Drugs​Pharmacies and Prescribers
​August 7, 2012​116 New Web Address for Pharmacy Program​Pharmacies and Prescribers
​July 20, 2012​115Peer Review Programs Expanded to Include Children up to Age 10​Pharmacies and Prescribers
​July 3, 2012​114Changes in Preferred Brands vs Generics: Kadian and Roxicodone​Pharmacies
​June 27, 2012​113Preferred Drug List July 1, 2012​Prescribers and Pharmacies
June 8, 2012112 Updates to List of Brand Drugs Preferred vs Generics on the Maryland Medicaid PreferredPharmacies and Prescribers
May 30, 2012111 Lipitor No Longer Brand Preferred on Maryland Medicaid Preferred Drug ListPrescribers and Pharmacies
April 25, 2012110 Medicaid Prefers Brands Lexapro and Geodon Pharmacies and Prescribers
February 3, 2012109 Medicaid Temporarily Authorizes Brand Prevacid Solutabs Prescribers and Pharmacies
January 4, 2012108 Late Refills for HIV Drugs - AgainPharmacies

2011

Date

Number

Subjects

Targeted Provider

December 29, 2011

107

Preferred Drug List Update

Pharmacies and Prescribers

December 29, 2011

106

Cost of Dispensing Analysis

Pharmacies

December 21, 2011 105

Holiday Payment Schedule

Pharmacies
December 20, 2011 104

Transition to D.0

Pharmacies
December 20, 2011 103

Transition to D.0 for LTC Pharmacies

Pharmacies
December 13, 2011 102

Changes in Preferred Multisource Brands on PDL, Use DAW 6

Prescribers and Pharmacies
December 5, 2011 101

Clarify Regulation Changes

Pharmacies
November 30, 2011 100

Pharmacy Services Regulation Changes

Pharmacies
November 4, 2011 99

Late Refills for HIV/AIDS Medications

Pharmacies and Prescribers
October 7, 2011 98

Peer Review Program for Antipsychotics

Pharmacies and Prescribers
June 30, 2011 97

Preferred Drug List Update

Pharmacies and Prescribers
June 29, 2011 96

Dispensing Fee Changes

All Pharmacies
June 28, 2011 95

Preferred Brands on the PDL, Use DAW 6

Pharmacies and Prescribers
June 27, 2011 94Pharmacies
June 23, 2011 93

Quantity Limits and Dose Optimization

Physicians and Pharmacies
May 13, 2011 92

OIG Audits

Pharmacies
May 13, 2011 91

List of Preferred Multisource Brands Has Changed

Prescribers and Pharmacies
April 29, 2011 90

Notice of Survey for Dispensing Fee

Pharmacies
March 23, 2011 89

Kapvay for Ages 6-17 Moved to Mental Health Carve-Out

Pharmacies and Prescribers
February 25, 2011 88

Important Changes Related to Prior Authorization Requests for Fee-for-Service Members

Pharmacies and Prescribers

2010

Date

NumberSubjectsTargeted Provider
September 30, 201087

Generic vs Brand on the Preferred Drug List

Prescribers and Pharmacies
September 30, 201086

Updated Preferred Drug List Effective October 1, 2010

Prescribers and Pharmacies
July 19, 201085

Reminder: Tamper Resistant Prescriptions Required for Medicaid Rx

Prescribers and Pharmacies
June 28, 201084

Intuniv Moved to Mental Health Formulary for MCO Members Aged 6-17 Effective July 1, 2010

Prescribers and Pharmacies
April 16, 201083 Limited Coverage of OTC Drugs for Dual Eligibles Prescribers and Pharmacies
April 1, 201082 Few Exceptions to Generic Substitution Prescribers and Pharmacies
March 31, 201081 Preferred Drug List Effective April 1, 2010 Prescribers and Pharmacies
March 1, 201080 Over the Counter Plan B Coverage Pharmacies
February 9, 201079 Rubber Stamped Prescribed Are Invalid Prescribers and Pharmacies
January 2678 Effective handling of Claim Rejections Pharmacies

2009

Date

Number

Subjects

Targeted Provider

December 1877 Holiday Closings Pharmacies and Prescribers
October 976 Update on mass Adjustments of legend Insulins Pharmacies
October 175 Over-the-Counter Plan B Coverage Up-Date Pharmacies
October 274 Some Multisource Brand Name Drugs Preferred Over Generics Pharmacies and Prescribers
October 173 Preferred Drug List Effective October 1, 2009 Pharmacies and Prescribers
October 172 Changes for the Status of Antipsychotic Medication on Preferred Drug List Prescribers
September 3071 30-Day Emergency Supply of Atypical Antipsychotics Pharmacies
September 2470 Mass Adjustment for Legend Insulins Pharmacies
June 2969 Changes in Mental Health Carve Out Pharmacies and Prescribers
May 1968 New Denial Codes for Non-rebatable Drugs, DESI and Obsolete Drugs Pharmacies
April 2267 Not all Generics are Preferred Pharmacies and Prescribers
April 966 Preferred Drug List Effective April 1, 2009 Pharmacies and Providers
April 765 Maryland Medicaid May Cover up to a 30-day Emergency Supply of Atypical Antipsychotics Pharmacies
March 2464 Time Limit Extended for Filing Claims Pharmacies
February 1863 Prescriber NPI Required on Pharmacy Claims, Effective March 1, 2009 Prescribers
February 1862 Claim Must Have Prescriber NPI Pharmacies

2008

Date

Number

Subjects

Targeted Provider

December 2261 Pharmacy Hotline Holiday Schedule Pharmacies
December 960 Depo-medroxyprogesterone Pharmacies
December 159 Payments Delayed One Week Pharmacies
September 2458 30-day Emergency Supply May be Available for Atypical Antipsychotic Prescriptions Pharmacies
September 2257 Required Tamper-resistant Pad Features Effective October 1, 2008 Pharmacies
September 2256 Required Tamper-resistant Prescription Pad Features Effective October 1, 2008 Prescribers
September 1855 Automatic Correction of Underpayments for CellCept, Lunesta, Xopenex, Fuseon kit and Travatan Z Claims Pharmacies
September 1254 Scheduled Down Time for Medicaid Claims Processing SystemPharmacies
August 2053 Physician Administered Medications Prescribers
July 1652 Intervention Codes Pharmacies
July 1551 Pain Management Agreements Prescribers
June 2550 Information about Formularies, PDL and PAs at Epocrates.com and DHMH website Prescribers and Pharmacies
May 249 Prescriber NPI Pharmacies
April 1148 POS System Maintenance Pharmacies
April 347 Preferred Drug List, effective April 1, 2008 Prescribers and Pharmacies
March 2646 NPI Information for Prescribers Prescribers and Pharmacies
March 745 Tamper Resistant Prescription Pad Features to be Phased in Beginning April 1, 2008 Prescribers and all Pharmacies
February 2644 Reminder: At Least One Recognized Tamper Resistant Feature Required as of April 1, 2008 on all Written Medical Prescriptions Prescribers and all Pharmacies
February 1243 Temporary Technical Difficulty Processing Medstar Family Choice Claims All Pharmacies
February 642 March 1- NPI Required on Claims Providers

2007

DateNumberSubjectsTargeted Provider
December 2741 Atypical Antipsychotics, Zyprexa Step Therapy, AIDS/HIV Drugs Carved Out from MCOs, Refills of Controlled Drugs Providers and Prescribers

 

October 140 Tamper-Resistant Prescription Pads Are Delayed Until April 1, 2008 Prescribers and all Pharmacies
August 2939 Changes to Preferred Drug List Prescribers and all Pharmacies
May 938 Correction of Underpayments, Over-the-Counter Plan B Coverage, Clinical Criteria for Cymbalta, Coordination of Benefits Prescribers and all Pharmacies
Apr. 1237 Possible Underpayments, Unacceptable Prescriber DEA Numbers, Early Refills for Recently Discharged Long Term Care Prescribers and all Pharmacies
Mar. 2836 Explanations of Some Claim Rejection Messages, New EVS Inquiry Phone Number, NPI Reminder, and Changes to Preferred Drug List (PDL) effective April 2007 All Pharmacies
Feb. 935 Late Payments All Pharmacies
Feb. 534 New Medicaid POS Claims Processor All Pharmacies
Jan. 24

33

POS System To Be Shutdown: New Fax Numbers for PAs All Pharmacies
Jan. 17

32

Reminder - POS Provider Training All Pharmacies

2006

Date

Number

Subjects

Targeted Provider

Dec. 21

31

New POS Processor; Zocor®; Prescription Transfers; Part D Questions All Pharmacies
Oct. 5

30

Pharmacy Dispensing Fee Survey All Pharmacies
Sept. 27

29

Changes to the Preferred Drug List; New EVS System; Narrow Therapeutic Index Drugs Prescribers and all Pharmacies
July 28

28

Brand Name PDL Anomalies Useful Medicare Part D Phone Numbers Prescribers and all Pharmacies
June 29

27

New Primary Adult Care Prescribers and all Pharmacies
May 11

26

New Primary Adult Care Program (PAC) Medicare Part D Exception and Prior Authorization Request Form Prescribers and all Pharmacies
March 23

25

Revised Preferred Drug List Transition from Pharmacy Assistance to Medicare Part D Prescribers and All Pharmacies
March 2

24

Dummy DEA Numbers Medicare Pare D Issues All Pharmacies
Feb. 22

23

Changes to the Preferred Drug List (PDL) Effective April 2006 Prescribers and all Pharmacies
Jan 10.

22

Useful Medicare Phone Numbers & Medicaid Coverage of Drug Classes Excluded from Medicare Part D Basic Plans All Pharmacies

2005

Date

Number

Subjects

Targeted Provider

Dec. 16

21A

Temporary Suspension of Early Refill Edits for Medicare Recipients Prescribers
Dec. 14

21

Temporary Suspension of Early Refill Edits for Medicare Recipients All Pharmacies
Nov. 23

20

Medicare Part D Prescribers and all Pharmacies
Sept. 16

19

Changes to the Preferred Drug List (PDL) Step Therapy for Stimulants and Related Agents

Revised Quantity Limits for Emend

Prescribers and all Pharmacies
Sept. 12

18

Hurricane Katrina Evacuees and Maryland Medicaid Program Prescribers 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 28

16

Claims Processing Upgrade Notes All Pharmacies
April 13

15

Planned Claims Processing System Maintenance All Pharmacies
March 1

14

Further Clarification: Atypical Antipsychotic Dose Optimization Appropriate Use of Palladone Grandfathering Non-Preferred Mental Health Drugs Prescribers and all Pharmacies

 

2004

 

2003

Date

Number

Subjects

Targeted Provider

Dec. 12

4

Revised Preferred Drug List (PDL): Cumulative Update for Prescribers Prescribers
Nov. 3

3

Preferred Drug List (PDL Implementation) PDL Instructions for the Prescriber Prescribers
Oct. 31

2

Preferred Drug List (PDL Implementation) PDL Instructions for the Pharmacist Community Pharmacies
Oct. 9

1

Change in Pharmacy Assistance Co-pay Community Pharmacies

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