Important Change in the Coverage of Prescription Drugs for Ohio Medicaid Consumers

Effective February 1, 2010, prescription drug coverage for Ohio Medicaid managed care plan (MCP) consumers will be covered by the Ohio Medicaid fee-for-service program, rather than the MCPs.

Ohio Medicaid covers prescription drugs and the following medical supplies for members of Medicaid managed care plans when dispensed at a pharmacy.

• diabetic supplies
• inhaler spacers
• peak flow meters
• syringes
• needles
• alcohol wipes
• condoms

Ohio Medicaid also covers drugs administered by home health agencies.

Further information on prescription drug coverage is available at the Ohio Department of Job and Family Services website at http://jfs.ohio.gov/ohp/bhpp/meddrug.stm, including:

• Ohio Medicaid Approved Drug List
• Quick Drug List
• Claims Submission Information
• Ohio Medicaid Provider Manual
• Drugs Requiring Prior Authorization

Questions regarding prior authorization and claims for prescription drugs should be directed to ACS, Ohio Medicaid's pharmacy vendor at 877-518-1546.

Molina Healthcare covers drugs administered in a provider setting, including:

• physician office
• hospital
• outpatient department
• clinic
• dialysis center
• infusion center

Medical supplies, other than those listed above, are covered by Molina Healthcare.

If you have questions regarding drugs administered in a provider setting or Molina Healthcare covered DME items, call Molina Healthcare provider services at 800-642-4168 (TTY for the hearing impaired 800-750-0750 or 711).

Drug Classes Requiring Prior Authorization When Administered in a Provider Office

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