Drug Utilization Review (DUR) and Pharmaceutical and Therapeutics (P&T) Websites Update |
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The Drug Utilization Review (DUR) and Pharmaceutical and Therapeutics (P&T) websites are temporarily inaccessible due to the Change Healthcare outage. Meeting notices will be posted on this page until the DUR and P&T websites are operational again. |
The purpose of the Iowa Medicaid Pharmacy page is to guide providers to available Iowa Medicaid Pharmacy resources.
Pharmaceutical and Therapeutics (P&T) Committee
House File 653 established a requirement for the Pharmaceutical and Therapeutics (P&T) Committee and the Drug Utilization Review (DUR) Commission to request and consider information from individuals who possess scientific or medical training with respect to drugs and biological products for rare diseases and drugs and biological products that are genetically targeted when making recommendations or determinations regarding beneficiary access.
To learn more about the process for written public comment submission for drugs and rare diseases for the upcoming P&T Committee meeting on August 15, 2024, click here.
Pharmaceutical and Therapeutics Committee
Drug Utilization Review (DUR) Committee
House File 653 established a requirement for the Pharmaceutical and Therapeutics (P&T) Committee and the Drug Utilization Review (DUR) Commission to request and consider information from individuals who possess scientific or medical training with respect to drugs and biological products for rare diseases and drugs and biological products that are genetically targeted when making recommendations or determinations regarding beneficiary access.
To learn more about the process for written public comment submission for drugs and rare diseases for the upcoming August 7, 2024, DUR meeting, click here.
Drug Utilization Review Committee
Medicaid Pharmacy Program Documents
- PDL Effective July 1, 2024
- Prior Authorization Criteria Chart - July 2024
- Quantity Limits List - January 1, 2024
- Brands Preferred over Generics - June 1,2024
- OTC Drug List by Category - July 1, 2024
- Fifteen Day Initial Prescription Supply Limit List - Effective June 1, 2024
To see archived pharmacy documents, please click here.
Pharmacy Rate Setting
Pharmacy Resources
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Iowa Medicaid PDL
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Provider Policy Manuals
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Pharmacy Dispensing Fee
This is also linked on the Iowa Medicaid Fee Schedule homepage.
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Fee Schedules
Select ‘Open Fee Schedules’ from the homepage to view the Pharmacy Fee Schedules.
Type Code 82 – Pharmacist
Type Code 08
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Informational Letters
ILs
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Provider Enrollment
MCO Provider Resources
To view provider resources under one of the managed care organizations (MCOs), please visit the below links.
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