Anthem New York Medicaid Asthma medication preferred/nonpreferred list and PA note
Provides hot-tip level formulary guidance for New York Medicaid prescribers about preferred and non-preferred asthma controller and rescue inhaler products, and a prior authorization note for children under 6 for Asmanex Twisthaler; mentions 90-day retail fill availability for controller medications.
Lists preferred and non-preferred asthma controller and rescue products and highlights PA requirement for children under 6 with an exception for Asmanex Twisthaler.
What is changing
Hot-tip (quarterly): This bulletin provides quick formulary guidance for New York Medicaid prescribers on preferred vs non-preferred asthma controller and rescue inhaler products to help minimize pharmacy claim rejections and delays. Prescribers are advised to prescribe preferred products when possible and to confirm prior authorization and step therapy requirements on the provider website, as coverage may change quarterly.