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June 19, 2006
 
 
 
 
MEDICAID INFORMATION RELEASE 2006-19
 
TO:                 Prescribing Providers, Pharmacists, and Pharmacies
 
FROM:           Leslie M. Clement,  Administrator
 
SUBJECT:      Preferred Agents for Drug Classes Reviewed at May 19, 2006 Pharmacy and Therapeutics Committee Meeting
 
Drug/Drug Classes:
Noted below
Implementation Date:
Effective for dates of service on or after July 1, 2006
 

Idaho Medicaid is designating preferred agents and prior authorization criteria for the following drug classes as part of the Enhanced Prior Authorization Program. The information is included in the attached Preferred Drug List.
 
Drug Classes Reviewed at May 19, 2006 P&T Meeting
ACE Inhibitors/Calcium Channel Blockers
Angiotensin-2 Receptor Antagonists
Anticonvulsants
Benign Prostatic Hyperplasia (BPH) Treatments
Bladder Relaxant Preparations
Cephalosporins and Related Antibiotics
Cytokine and CAM Antagonists
Erythropoiesis Stimulating Proteins
Growth Hormones
Hepatitis C Agents
 
Injectable Anticoagulants
Lipotropics
Meglitinides
Multiple Sclerosis Agents
Narcotic Analgesics, Long-Acting and Short-Acting
Otic Antibiotics
Phosphate Binders
Proton Pump Inhibitors
Sedative Hypnotics
Thiazolidinediones (TZDs)
 
Questions regarding the Prior Authorization program may be referred to Medicaid Pharmacy at (208) 364-1829.A current listing of all the preferred agents by drug class and prior authorization criteria is also available online at www.medicaidpharmacy.idaho.gov.
 
IDAHO MEDICAID PROVIDER HANDBOOK
This Information Release does not replace information in your Idaho Medicaid Handbook.