Medicaid Pharmacy Archive

• PDL Effective June 1, 2024
• PDL Effective January 5, 2024

• Prior Authorization Criteria Chart - June 2024
• Prior Authorization Criteria Chart - January 2024

• Quantity Limits List - January 1, 2024

• Brands Preferred over Generics - January 1, 2024

• OTC Drug List by Category - January 26, 2024

• Fifteen Day Initial Prescription Supply Limit List - Effective June 1, 2024

• Updated March 29, 2024: Change Healthcare’s pharmacy point-of-sale (POS) system for Iowa’s Fee-For-Service (FFS) population is operational as of March 28, 2024, at 2:00 p.m. Pharmacies are able to process claims for FFS members. Providers and pharmacies may contact the POS helpdesk at 1-877-463-7671 or 515-256-4608 (local). Please see additional information here.
• Updated February 26, 2024: Change Healthcare experienced a nationwide outage with their pharmacy point-of-sale system for Iowa's Fee-For-Service (FFS) Medicaid population. This affected eligibility lookup, prior authorization and billing.  Read more about the outage at Change Healthcare Cyberattack Information.

This outage does not affect members assigned to and receiving pharmacy benefits through a managed care organization (MCO) like Iowa Total Care, Molina Health Care of Iowa or Wellpoint Iowa.