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2011 Formulary A current list of covered drugs representing the prescription therapies believed to be a necessary part of a quality program. The Formulary may change throughout the year as we add new less expensive generic drugs, remove drugs that are determined to be unsafe or ineffective, or add prior authorization, quantity limits and/or step therapy restrictions on a drug.
2011 Formulary PA Criteria
2011 Formulary ST Criteria
2012 Formulary H5209-002_H7475-001_CWHPFC07-14-11A CMS Approved 09/06/2011 A current list of covered drugs representing the prescription therapies believed to be a necessary part of a quality program. The Formulary may change throughout the year as we add new less expensive generic drugs, remove drugs that are determined to be unsafe or ineffective, or add prior authorization, quantity limits and/or step therapy restrictions on a drug. 2012 Formulary Medicaid Supplement_H5209-002_H7475-001_CWHPFMS07-14-11A CMS Approved 08/02/2011
2012 Formulary PA Criteria
2012 Formulary ST Criteria
Part D Formulary Transition Policy and Procedure
Medicare Part D Low-Income Subsidy (LIS) Premium Assistance Prescription Drug Grievance, Appeal, Coverage Determination and Exception Processes
H5209-002_H7475-001_CWHPWEB_12-21-11A CMS Approved 12/29/2011 Last Updated 12/21/2011 DHS Approved 12/22/2011
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