To view the Molina Healthcare of Idaho Medicaid Formularies, click below:
Idaho Medicaid Plus Searchable Formulary
Idaho Medicaid Plus Drug List
SureScript Real-Time Prescription Benefits
The foll...
Molina Healthcare of Michigan periodically publishes Partners in Care newsletter for our valued physicians. This publication offers in-depth information on Molina's programs and services. We strive to...
Prior Authorization Request Form
Prior Authorization Medications Form
Universal Synagis Prior Authorization Form
Adobe Acrobat Reader is required to view the file(s) above. Download a no-cost ...
For Managed Medicaid & HARP members:
Starting April 1, 2023, prescriptions will not be covered by Molina Healthcare. They will be covered by Medicaid NYRx, the Medicaid pharmacy program.
Medicaid ...
Here you can find all your provider forms in one place. If you have questions or suggestions, please contact us.
Authorizations / Utilization Management Forms
Prior Auth LookUp Tool
Prior Authorizatio...
Participation Guidelines and Standards of Care
Provider Guidelines:
All Participating Providers are expected to:
Perform duties in their area of specialty.
Provide preventive care services, i...
Please familiarize yourself with the Drug Formulary as you prescribe medications for Molina Healthcare members. Thank you for your cooperation.
Preferred Drug List (PDL) & Rx Prior Authorization Form...
The guidelines below were reviewed and adopted by the Molina Healthcare National Quality Improvement Committee. Committee approval dates are shown for 2015 and beyond. All guidelines are reviewed m...
To receive information: The right to receive information about Molina Healthcare, its services, its policies and procedures, practitioners and providers and member rights and responsibilities.
To advo...
