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12/06/2018

Movement toward Medicaid unified PDL begins on Jan. 1

The Ohio Department of Medicaid (ODM), in partnership with the Medicaid managed care plans (MCPs), is moving toward creating a unified preferred drug list (PDL). The goals of this initiative include:
  • Allowing for a standard process across Ohio Medicaid fee-for-service (FFS) and the MCPs to support population health initiatives.
  • Reducing administrative burden for physicians and other health care professionals by simplifying and streamlining the prescribing and prior authorization processes .
  • Minimizing member movement across MCPs.

Beginning Tuesday, January 1, 2019, all Ohio Medicaid MCPs will prefer the same medications and use the same prior authorization criteria for diabetes drugs (insulin and non-insulin), hepatitis C drugs, and medication assisted treatment (MAT) for opioid use disorder. The ODM is using a phased-in approach to build a unified PDL, adding more categories to it later in 2019.

View the unified PDL 2019.

Prescribers may refer to the ODM Pharmacy website under “Drug Coverage” for more information or can contact the ODM with questions or concerns.

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