March 2010

 

DMA established a Preferred Drug List (PDL) on March 15, 2010 to obtian better prices for covered outpatient drugs through supplemental rebates. Initially, there will be NO changes in the drugs that are currently covered.  In the future, selected therapeutic drug classes will be reviewed and specific drugs defined as "preferred." Generally, these drugs will not require Prior Authorization(PA) unless there are other clinical PA requirements such as step therapy or quantity limits.

"Non-preferred" drugs will be available if prior authorization criteria are met.  The PA process will be the same as it is today.  The prescriber will be responsible for initiating a PA request.  For therapeutic drug classes that do not appear on the PDL, nothing has changed.

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CHRONIC CARE

In 2005, the NC General Assembly requested that Community Care of North Carolina (CCNC) utilize its disease management strategies to help manage the care of the Medicaid Aged, Blind, and Disabled populations in North Carolina.  In association with CCNC and the Division of Medical Assistance (DMA), 4C continues to lay the ground work for the Cumberland County pilot program that will target enrollees within this population that have a potential for successful self-management.

 

Establishing relationships with community agencies that provide care to the aged, blind and disabled population is important to this initiative.  The aim objective is to help coordinate goal-driven collaborative plans of care that will strengthen the enrollee’s ability to manage their chronic care needs.

 

Heart Failure is the first step toward meeting one of the Chronic Care Project objectives.

 

4C welcomes input that will help us better serve the aged, blind and disabled population. E-mail your questions and/or comments to us.

 

For more information about diabetes, visit the websites below or call 4C!

 

NC Medicaid's Aged, Blind and Disabled Program

Heart Failure Society of America

What is Heart Failure?

Tips for Family and Friends

 
 

Carolina Collaborative Community Care (4C)

Phone: (910) 485-1250 Fax: (910) 485-7238