Pharmacy Updates

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Pharmacy Updates Archives

2024

• Coverage Changes to Herzuma® – Effective November 11, 2024 (October 28, 2024)
• Tirosint®, Tirosint®-SOL, Flector®, and Licart® Coverage Changes Effective October 1, 2024 (October 09, 2024)
• Action Required by 09/24/2024 – Oklahoma Complete Health Medicaid Network Provider Agreement (September 19,2024)
• COVID-19 Public Health Emergency (PHE) Unwinding Updates (September 16,2024)
• Prior Authorization of Riluzole Tablets – Effective September 16, 2024 (September 4,2024)
• Flu Vaccine Coverage for the 2024-2025 Flu Season (August 27, 2024)
• Alinia®, Anti-Diabetic Medications, and Pylera® Coverage Changes Effective July 22, 2024 (July 8, 2024)
• Prior Authorization of Aliqopa® – Effective July 1, 2024 (June 17, 2024)
• ADHD Medications and Nuvigil® Coverage Changes Effective May 13, 2024 (April 29, 2024)
• Anti-Migraine Medications Coverage Changes Effective April 22, 2024 (April 8, 2024)
• Renagel® and Fosrenol® Coverage Changes Effective April 8, 2024 (March 25, 2024)
• Toviaz®, Cerdelga®, Zavesca®, Alphagan® P, Zioptan®, Ciprodex®, and Floxin® Otic Coverage Changes Effective March 25, 2024 (March 11, 2024)
• Pharmacy Benefit Changes for Gender Transition Related Hormone Therapy in Minors (February 20, 2024)
• Anti-Diabetic Medication Shortages (February 5, 2024)
• Breo® Ellipta®, Spiriva® HandiHaler®, and Pradaxa® Coverage Changes Effective January 29, 2024 (January 15, 2024)
• Potential Downtime in SoonerCare Point-of-Sale System (January 10, 2024)

2023

• 2024 Plan Changes Effective January 1, 2024 (December 18, 2023)
• Dulera® 50mcg/5mcg, Topical Corticosteroids, Vogelxo® 1% Pump Coverage Changes (October 30, 2023)
• Revised COVID Vaccine Billing Guidance for the 2023-2024 Season & Vyvanse® Reminder (October 16, 2023) 
• COVID Vaccine Coverage for the 2023-2024 Season (October 2, 2023)
• Vyvanse® Reminder (September 20, 2023)
• Renewing SoonerCare Coverage (September 12, 2023)
• ADHD Medications, Xyrem®, Risperdal Consta®, and Tirosint® capsules Coverage Changes (September 11, 2023)
• Flu Vaccine Coverage for the 2023-2024 Flu Season (August 28, 2023)
• Prior Authorization of Nyvepria™ (August 28, 2023)
• Naloxone Standing Order (August 14, 2023)
• Anti-Diabetic Medications, Carafate®, Pylera®, and Ravicti® Coverage Changes (June 26, 2023)
• Migration to AWS (May 25, 2023)
• PHE QL Changes (May 10, 2023)
• Makena FDA Withdrawal (April 17, 2023)
• Letairis® (Ambrisentan) Coverage Update (April 10, 2023)
• Banzel®, Combigan®, Tazorac® Gel, and Welchol® Packets for Oral Suspension Coverage Changes (March 27,2023)
• Aspirin for Prevention of Preeclampsia, Pentasa Brand Preferred (February 6, 2023)

2022

• Plan Changes 2023 - All Pharmacies (December 15, 2022)
• Plan Changes 2023 for Cystic Fibrosis (December 15, 2022)
• PA of Lonsurf® and Stivarga® (November 29, 2022)
  
• Durezol®, Testosterone Products, Topical Corticosteroids, Hydrocodone/ Ibuprofen 10/200mg Coverage Changes (November 22,2022)
• PA Changes (October 24, 2022)
• Flu Vaccine Coverage for the 2022-2023 Flu Season, Albuterol HFA (September 6, 2022)
• Mavyret® (Glecaprevir/Pibrentasvir) Update (August 29, 2022)
• Qnasl® 80mcg, Albuterol HFA, Naloxone Reminder (August 1, 2022)
• Expiring Pharmacies (June 6, 2022)
• Azopt® 1%, Istalol® 0.5%, Jakafi® Coverage Changes (April, 4, 2022)

2021

• Cabometyx® and Herceptin® (December 29, 2021)
• Vyvanse® Chewable Tablets, QuilliChew ER®, and Diabetic Testing Supplies Coverage in 2022 (December 28, 2021)
• COVID-19 Test Coverage and Pediatric COVID-19 Vaccine Coverage (December 20, 2021) 
• 2022 Plan Changes (December 16, 2021)
• Zoladex Coverage Ended - Provider Letter (December 15, 2021)
• 2022 Diabetic Supplies Changes (December 15, 2021)
• Smoking Cessation (November 29, 2021)
• COVID -19 Vaccine Update on Additional and Booster Doses (November 1, 2021)
• Synagis (October 5, 2021)
• Flu Vaccine Coverage (September 7, 2021)
• Strattera G-CSF and Contraceptive Diagnosis (June 14, 2021)  
• Ninlaro Sarclisa and Xpovio (May 24, 2021)
• Lenvima and Santyl (April 26, 2021)
• COVID-19 Vaccine Updates (March 22, 2021)
• COVID-19 Vaccine, ACIP and VFC (March 15, 2021)
• Rubraca and Zejula (February 22, 2021)
• Cystaran and generic Epclusa (February 15, 2021)

2020

• 2021 Tier Changes (December 14, 2020)
• Suboxone Films, Tirosint Updates (November 22, 2020)
• Synagis (October 5, 2020)
• Flu Vaccines (August 24, 2020)
• Prenatal Updates - Providers (June 15, 2020)
• Prenatal Updates - Rx (June 15, 2020)
• Brand Preferred List (June 15, 2020)
• Diagnosis on RX (April 20, 2020)
• Briviact Changes (April 3, 2020)
• Hydroxychloroquine/Chloroquine/SCC13/Ranitidine (April 2, 2020)
• COVID-19 Emergency (March 20, 2020)
• Symbicort Brand Preferred (February 20, 2020)
• Maintenance Drug List (January 27, 2020)

2019

• Step Therapy Changes 2020 (December 16, 2019)
• Pharmacy J-code Billing/Topical Corticosteroid (October 14, 2019)
• Synagis (September 25, 2019)
• Opioid MME edit Phase IV (September 16, 2019)
• Lymphoma PA (September 16, 2019)
• 2019-2020 Flu Vaccines (September 11, 2019)
• Rozerem Brand Preferred/Sklice (September 9, 2019)
• Provider Letter Aldurazyme & Naglazyme (September 2, 2019)
• Opioid MME edit Phase IV (August 19, 2019)
• Diclegis, Lyrica, Methylin, and Seconal Sodium (August 12, 2019)
• Medication Assisted Treatments (July 19, 2019)
• Opioid MME edit Phase III (May 20, 2019)
• Suboxone Coverage Update (April 22, 2019)
• Opioid MME edit Phase II reminder (April 8, 2019)
• Server Outage Reminder (March 19, 2019)
• TCS-Glaucoma-NDC Billing-Outage (March 4, 2019)
• Opioid MME edit Phase II (February 18, 2019)
• Topical Steroids & Eucrisa (January 28, 2019)
• Early Refill Threshold Changes (January 25, 2019)
• CII Scripts by Mid-Level Practitioners (January 7, 2019)

2018 

• 2019 Step Therapy Tier Changes (December 17, 2018)
• Opioid MME edit Phase 1 (November 19, 2018)
• Hypertension (October 30, 2018)
• Provider Rate Increase-Dispensing Fee (October 25, 2018)
• Opioid Law/Treshold Changes/Fycompa (October 1, 2018) 
• Synagis (September 26,2018)
• Flu Vaccines (September 5, 2018)
• Pharmacy/DME Contract Renewal (August 6, 2018)
• Sabril Brand Preferred (July 17, 2018)
• Otiprio Provider Letter (May 7, 2018)
• Prenatals (May 7, 2018)
• Migraine/Glaucoma/Pazeo (April 4, 2018)
• Promacta/Nplate (February 7, 2018)
• PPI Prescriber Letter (February 19, 2018)
• Xifaxan (January 13, 2018)
• ALL/CML (January 17, 2018)
• Antiulcer/NSAID/TCS (January 10, 2018)

2017  

• Step Therapy Changes (December 18, 2017)
• Aczone/Tazorac (November 11, 2017)
• Xopenex HFA (November 7, 2017)
• Vitamin D Analogs (November 6, 2017)
• Antivirals (October 30, 2017)
• Xenazine (October 23, 2017)
• Codeine/Tramadol (October 16, 2017)
• Synagis (October 2017)
• Tobi Podhaler (September 27, 2017)
• Antidepressants / Fibric Acid (September 20, 2017)
• Compound / Adult OTC Coverage (September 18, 2017)
• 2017-2018 Flu Vaccines (September 5, 2017)
• Lung Cancer (September 1, 2017)
• Opana ER (August 16, 2017)
• Strattera (August 10, 2017)
• ADHD Update (August 8, 2017)
• Kuvan (August 2, 2017)
• Compound Products (May 8, 2017)
• Phosphate Binders (May 1, 2017)
• Veltassa Fax (April 24, 2017)
• Skin Cancer (March 27, 2017)
• Pancreatic Enzymes (February 13, 2017)
  
• Iron Overload (January 30,2017)

2016  

• Pricing Rule Changes (December 19, 2016)
  
• 2017 Tier Changes (December 8, 2016)
• Topical Steroid and butalbital medications (November 28, 2016)
  
• Prescriber Edit Denials (November 23, 2016)
• Spiriva Respimat (November 14, 2016)
• Methadone (November 7, 2016)
• Nasal Allergy (October 31, 2016)
• Ophthalmic Antibiotics/Glaucoma (October 24, 2016)
  
• Opioid Overdose Education and Naloxone Distribution (October 10, 2016)
  
• H.P. Acthar Gel (October 5, 2016)
  
• Neulasta, Granix, and Zarxiox (October 5, 2016)
  
• Prostate Cancer Treatments (October 3, 2016)
  
• Topical Antifungal and Albenza (September 21, 2016)
  
• Synagis (September 19, 2016)
  
• Fall Provider Training (September 12, 2016)
  
• Bowel Prep (September 7, 2016)
  
• 2016-2017 Flu Vaccines (August 19, 2016)
  
• Oxycontin Brand Preferred (August 15, 2016)
  
• Vimpat Banzel and Fycompa (May 25, 2016)
• UC & CD - mealamine products (May 18, 2016)
  
• Cortisporin Otic (May 11, 2016)
  
• Aggrenox (May 4, 2016)
• Migranal/DHE 45 (May 4, 2016)
  
• Noxafil/Cresemba (April 13, 2016)
  
• Nuelasta/Granix/Zarxio (March 15, 2016)
  
• APAP/IBU/Compounded Medications (March 6, 2016)
  
• Tetracycline/Fluoroquinolone Update (March 2, 2016)
• Spacers/Abilify (February 24, 2016)
  
• Cayston Kitabis Update (February 3, 2016)
  
• Breast Cancer Pharmacy Version (February 2, 2016)
  
• Breast Cancer Prescriber Version (February 2, 2016)
  
• NSAID and Topical Steroids (January 27, 2016)

2015 

• Step Therapy Tier Changes for 2016 (December 18th, 2015)
  
• Quantity Limit Edit Survey Results (November 18th, 2015)
  
• Synagis Criteria (October 1, 2015)
  
• Prednisolone Solution - Prescriber Version (September 30, 2015)
  
• Prednisolone Solution - Provider Version (September 30, 2015)
  
• Flu Vaccines (September 11, 2015)
  
• Copaxone Update (July 15, 2015)
• Naloxone Update (June 30th, 2015)
  
• Ofloxacin Otic (June 24, 2015)
• Quantity Limit Edit Survey for Opioids (June 16th, 2015)
  
• Abilify Brand 2 (June 9th, 2015)
  
• Abilify Brand (June 1, 2015)
• Prenatal, Contour Next, Spacers (May 12, 2015)
• Diabetic Supplies to POS 3 (April 10, 2015) 
• Diabetic Supplies to POS 2(March 20, 2015)
• Diabetic Supplies to POS (March 4, 2015)
• Opioid Edit Final Phase (January 5, 2015)

2014

• 2015 Step Therapy Changes (December 22, 2014)
• Sivextro, Dalvance, Orbactiv (December 15, 2014
• Opioid Analgesic Quantity Limits (October 27, 2014)
• Topical AntiFungal (October 7, 2014)
• Flu Vaccines(September 10, 2014)
• Pediculicides(August 15, 2014)  
• Ophthalmic Anti-Inflammatory/Corticosteroids (August 1, 2014)
• Compound Claim Changes (July 22, 2014)
• Dear Provider Letter Hep C (June 27,2014)
  
• Copay and Dispensing Fee Changes (June 27, 2014)  
• Pulmozyme-Tobi
• Prenatal Vitamins Fax Blast

2013

• Step Therapy Tier Changes (Dec. 18, 2013) 
• Flu Vaccine Coverage & Covered Flu Vaccines (Oct. 1, 2013)
• Synagis & Supplemental Synagis Dosing Form (Sept. 16, 2013)
• Limited Time-Free Pharmacy Bags (Jul. 31, 2013)
• ePocrates & Topical Corticosteroids (Jul. 24, 2013)
• Cumulative Early Refill & Automated Refills (Jul. 19, 2013)
• Montelukast (Singulair® ) Coverage Changes, Approval Criteria for Asthma & Allergic Rhinitis Diagnosis age 21 and older (Jun 14, 2013)
• State Board of Pharmacy Emergency/Disaster Rules in Effect for Counties Affected by the Recent Storms & 535:13-1-4. Pharmacy Emergency/Disaster Response (May 21, 2013)
• Chronic Obstructive Pulmonary Disease Medications Step Therapy, Orapred ODT PA & Diabetes Medications Step Therapy (Apr. 24, 2013)
• Narcotic Analgesics Age Restrictions (Solid Dose Forms), Billing Partial Units & Pharmacy Lock-In Program (Mar. 14, 2013)
• Emergency Compounding of an Oral Suspension from Tamiflu® 75mg Capsules, Smoking Cessation Coverage Changes & Atorvastation Now Has $0 Copay.(Feb. 13, 2013) 
• Opana ER Coverage and Narcotic Analgesic Prior Authorization (Feb. 1, 2013)

2012

• Step Therapy Tier Changes (Dec. 13, 2012)
• Topical Antifungal Medications Step Therapy & Drug Coverage for Dual Eligible Medicare Members (Dec. 3, 2012)
• Bladder Control Medications, Prior Authorization for Adcirca (tadalafil), Revatio (sildenafil) and Age Restrictions on Pediatric Dosage Forms (Nov. 21, 2012)
• Flu Vaccine Coverage & Covered Flu Vaccines (Oct. 10, 1012)
• Extended System Maintenance Window This Weekend, Prior Authorization Forms & Prescriber Fax Numbers (Jul. 19, 2012)
• Asmanex Package Size Change and New OHCA Phone System Update (Apr. 11.2012)
• Billing for OTC Products, Default Prescriber ID, New OHCA phone System and ePocrates (Mar. 23, 2012)
• Erythropoietin Stimulating Agents (ESAs) Prior Authorization, Continuation and Discontinuation Criteria (Mar. 16, 2012)
• Prenatal Vitamins Coverage (Mar. 5, 2012)
• Prior Authorizations Updates, Gout Agents, Uloric (febuxostat) and Bladder Agents (Mar. 5, 2012)
• Multiple Sclerosis (MS) Medications Prior Authorization (Feb. 24, 1012)
• OHCA System Now Available (Feb. 11, 2012)
• OHCA system Downtime Schedule 02/10/12 through 02/13/12, pharmacy claims will not be processed and OHCA pharmacy help desk will not be available, Non Covered Prescribers (Feb. 3, 2012)
• OHCA System Downtime Scheduled 02/10/2012 through 02/13/2012 and During maintenance window, pharmacy will not process claims and OHCA pharmacy help desk will not be available (Feb. 9, 2012)

2011

• Holiday Hours / Dispensing Emergency Supplies of Medications Transition (Dec. 21, 2011)
• Transition to NCPDP D.0, Step Therapy Tier Updates, Diabetes Medications & Biologic Products (Dec. 19, 2011)
• Transition to NCPDP D.0 & Holiday Hours (Dec. 15, 2011)
• Electronic Data Interchange & NCPDP D.0 Readiness Survey (Nov. 2, 2011)
• Topical Corticosteroids Step Therapy (Oct. 21, 2011)
• Billing for Inhalers and Nasal Sprays (Oct. 11, 2011)
• Change to Drug Reimbursement Calculation (Oct. 6, 2011)
• Brand name Neuroleptics, Flu Vaccine Coverage & Labor Day hours (Sep. 1, 2011)
• Updated Antihistamines Prior Authorization Tiers & Pradaxa to require Prior Authorization (Aug. 2, 2011)
• Anticonvulsants Quantity Limits, Antidepressants Prior Authorization and Independence Day (Jun. 28, 2011)
• Stimulant / ADHD Prior Authorization: New Criteria Effective June 20, 2011 (Jun. 8, 2011)
• Benign Prostatic Hyperplasia (BPH) Medications Prior Authorization, Insomnia Medications Prior Authorizations (May 25, 2011)
• Suboxone, Subutex Prior Authorization & Coverage Discontinued for Prescriptions Written by Non-OHCA Providers (Apr. 15, 2011)
• Prior Authorization update, Catapres TTS (clonidine) PA Criteria, Update Hypnotics PA tiers & Coverage discontinued for prescriptions written by Non-OHCA Providers (Apr. 11, 2011)
• Prior Authorization of Alzheimer's Medications & Coverage Discontinued for Prescription written by Non-OHCA Providers (Mar. 18, 2011)
• All ADHD Medications for Children Under Age 5 to Require Prior Authorization & Holiday Hours (Jan. 14, 2011)