As of Wednesday, March 18, HCA’s lobby is closed. In-person customer services for Apple Health and the PEBB and SEBB Programs will not be available. Learn more.
- New duration of use and dose limits for Proton Pump Inhibitors (PPI)
- Notice of pharmacy rates change in basis of payment
Unintentional overdose deaths are associated with methadone and other opioids. The Pharmacy and Therapeutics Committee (P&T) has asked the Health Care Authority (HCA) to distribute a special health advisory to pharmacists and prescribers.
Note: For information on billing and rates, expedited authorization (EA) codes, and the state maximum allowable cost list (SMAC), please visit the Prescription Drug Program on our provider billing guide and rates page.
- Agency Medical Director’s Group (AMDG) opioid prescribing guidelines/dose calculator
- Apple Health (Medicaid) Drug Coverage Criteria
- Request a pharmacy prior authorization
- Emergency fill policy
- NCPDP D.O. payer specification sheet
- Participating drug rebate manufacturers
To request a change in fee-for-service (FFS) reimbursement
Download the Pharmacy Information Authorization form (13-835A). Fax the request to: 866-668-1214.