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Drug Formulary
2024 Molina Dual Options STAR+PLUS MMP Drug Formulary Additional Pharmacy Benefit Information  2024 Prior Authorization Grid  2024 Step Therapy Grid  2024 Medicare Part D Drug (J-Code) Step Therapy G...
/providers/tx/duals/drug/formulary.aspx
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HIPAA 5010 Readiness
aMolina Healthcare’s HIPAA 5010 Readiness *Molina Healthcare is ready to test the 5010 versions of the HIPAA transactions with providers and other trading partners.  We look forward to working collabo...
/providers/tx/duals/hipaa/5010Readiness.aspx
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HIPAA Code Sets
The Federal HIPAA regulations issued by DHHS dictate that only approved code sets may be used in standard electronic transactions. The CMS site has official resources that define these standard code s...
/providers/tx/duals/hipaa/codesets.aspx
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HIPAA Security
aHIPAA Security Standards for the Protection of Electronic Protected Health InformationThe Final Rule adopting HIPAA standards for the security of electronic protected health information was published...
/providers/tx/duals/hipaa/security.aspx
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HIPAA Transactions
HIPAA Standards for Electronic Healthcare TransactionsHIPAA required the Department of Health and Human Services (HHS) to adopt national standards for electronic healthcare transactions. All covered e...
/providers/tx/duals/hipaa/tcs.aspx
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HIPAA Transaction Readiness
Since HIPAA’s inception, Molina Healthcare has worked diligently and collaboratively with the broader healthcare community to achieve compliance with the federal HIPAA transactions requirements. Molin...
/providers/tx/duals/hipaa/tcs_readiness.aspx
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Fraud Prevention Tips
Molina Healthcare of Texas seeks to uphold the highest ethical standards for the provision of health care benefits and services to its members and supports the efforts of federal and state authorities...
/providers/tx/duals/policies/fraud.aspx
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Policies
Molina has established Molina Clinical Policies (MCP) that function as one of the sets of guidelines for coverage decisions or determinations. MolinaClinicalPolicy.com includes the Molina-wide Clinica...
/providers/tx/duals/policies/policies.aspx
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Partners In Care Newsletters
Molina Healthcare of New Mexico periodically publishes the Partners in Care newsletter. Targeted to you, our valued physicians, this publication offers in-depth information on Molina's programs and se...
/providers/nm/marketplace/comm/newsletters.aspx
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Pharmacy Prior Authorization Form
New Mexico Prior Authorization Form New Mexico Synagis Prior Authorization Form
/providers/nm/marketplace/drug/pharmacy-prior-authorization-form.aspx