Welcome to the Maryland Medicaid Pharmacy Program fee-for-service (FFS) covered medication list on Formulary Navigator™
Effective January 1, 2020, antiretrovirals for the treatment of HIV (AHFS 8:18:08) will be carved into the HealthChoice MCO benefit from the FFS program.
Prescribers: Please consult the member’s MCO for coverage information and to determine the appropriate action by June 2020 to prevent treatment disruption.
Pharmacists: Please utilize the appropriate MCO billing information when submitting claims for this medication class.
Quick links:
Main Pharmacy Services Webpage: https://health.maryland.gov/mmcp/pap/Pages/paphome.aspx
Preferred Drug List: https://health.maryland.gov/mmcp/pap/pages/Preferred-Drug-List.aspx
Clinical Criteria: https://health.maryland.gov/mmcp/pap/pages/clinical-criteria.aspx
Prior Authorization information/forms: https://health.maryland.gov/mmcp/pap/pages/pharmacy-program-forms.aspx
Quantity Limits: https://health.maryland.gov/mmcp/pap/docs/QL.pdf
HealthChoice Managed Care Organization (MCO) information: https://health.maryland.gov/mmcp/healthchoice/Pages/Home.aspx