Member Policies - Medical Policies - Alabama
To contribute to improved transparency around clinical management, Magellan Rx’s Hemophilia Management services will be used to perform utilization management and oversight of specialty pharmacy dispensing as part of this program.
For groups that have their pharmacy benefits carved in and participate in Utilization Management, Magellan Rx will perform the Prior Authorization (PA) drug reviews. The PA reviews will ensure that optimal dosing and products are being prescribed.
These changes will go into effect starting on July 1, 2019.
Please review the hemophilia drug policies posted.
How to submit a PA
Prescribers may submit a Prior Authorization request through Eligibility & Benefits after logging into the website on the back of your member’s ID card, or by contacting Magellan Rx at 1-800-424-8270 on or after July 1, 2019.
Specialty Pharmacies seeking initial prior authorizations on behalf of the prescriber may complete the Hemophilia Prior Authorization Form or call MagellanRx at 1-800-424-8270.
After initial approval of a hemophilia drug PA, Specialty Pharmacies dispensing the hemophilia drugs will also be required to complete a Hemophilia Case Review Form to obtain a dose authorization from Magellan Rx prior to each dispensing of the drug. Through this additional dose authorization, Magellan Rx will ensure that appropriate assay management, inventory management, and patient engagement is being provided.
|Policy #||Policy Title||Print View|
|PH-133||Hemophilia Case Review Form|