June 2009

Dear Peach State Provider:

Peach State Health Plan  is making some important changes to our Preferred Drug List, and we are writing to communicate the changes to you. Effective September 1, 2009, the following changes will be made:

Member’s medication regimen is restricted two narcotic analgesic medications per month. This will include the products listed below.

Brands/generics (containing any of the following ingredients): 

1. Oxycodone
2. Hydrocodone
3. Propoxyphene
4. Codeine
5. Butalbital (not a controlled substance, but still has potential to be a drug of abuse)
6. Morphine
7. Methadone
8. Meperidine
9. Fentanyl
10. Buprenorphine
11. Oxymorphone
12. Hydromorphone
13. Pentazocine

 
As the member’s physician, If you feel that a patient will require medication therapy outside of the above guidelines, you are required to submit a prior authorization request to Peach State. The Medication Prior Authorization Request form is available on the Peach State website, www.pshp.com, in the Pharmacy Forms section. The completed form  must be  faxed to US Script at 1-866-399-0929 for review.

Thank you,

Wendy Bailey, RPh.                         Robyn Lorys, Pharm. D.
Director of Pharmacy                     Director of Clinical Pharmacy
Peach State Health Plan                 Peach State Health Plan

This entry is filed under News.