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THE 2009 HPM DRUG FORMULARY
Prescription Drug Plan Coverage HPM utilizes CVS/Caremark to manage our pharmacy benefit. CVS/Caremark provides HPM with a pharmacy network, pharmacy claims management services, a drug formulary and pharmacy claims adjudication. Prior to authorizing any drug benefit, each member's eligibility is determined. CVS/Caremark provides Provider Support at 1-888-883-0699. HPM providers may also speak with a clinical pharmacist regarding any pharmaceutical, medication administration or prescribing issues. Each PCP will receive a copy of the HPM Pharmacy Drug Formulary. The Drug Formulary is also available on our website at www.hpmich.com or through epocrates.com. This drug formulary should be accessible and be referred to when prescribing medications for HPM members. Medicaid members have both prescription and specific over-the-counter medication coverage. All providers must prescribe from within the drug formulary unless a drug prior-authorization is obtained from CVS/Caremark. There are also a few specialized medications in the drug formulary identified as requiring a prior-authorization. Obtaining a Drug Prior-Authorization If a provider wishes to prescribe a drug that requires prior-authorization and/or a drug is not in the drug formulary, he/she must complete a Drug Prior Authorization Request Form. This form must be faxed to CVS/Caremark Prior Auth Desk at: 1-866-855-2678. In emergency situations, please phone CVS/Caremark at 1-888-883-0699. Prior-authorizations must be obtained before providing the member with a written prescription. If a prior-authorization is not obtained in advance, the member will not be able to have the prescription filled at their pharmacy, causing a delay for the member in obtaining their medication. Glucometers for Diabetic Members Great Lakes Medical Supply provides Prodigy® non-coding, talking glucometers for HPM members with diabetes. For a member to receive a glucometer the PCP must complete a Physician Order Form and forward it to Great Lakes Medical Supply at Fax # 1-800-292-0677 or call 1-800-774-0788. The initial glucometer will be shipped to the member within 24 hours of receipt of a completed request. The package received will include:
For more information on the Prodigy® Glucometer, please visit: http://www.prodigymeter.com/home.cfm |
