Bulletin Results


Program Office Acronyms
OA - Office of Administration
OCDEL - Office of Child Development and Early Learning
OCS - Office of Client Services
OCYF - Office of Children, Youth, and Families
ODP - Office of Developmental Programs
OIM - Office of Income Maintenance
OLTL - Office of Long Term Living
OMAP - Office of Medical Assistance Programs
OMHSAS - Office of Mental Health and Substance Abuse Services
OSP - Office of Social Programs

Note: All Program Office Bulletins are not yet posted. Program Offices are currently in the process of adding bulletins to the website.

Bulletin Number(s) Program(s) Subject/Title Issue Date Effective Date
OMHSAS-19-04 OMHSAS Guidelines for Implementing Assisted Outpatient Treatment 11/06/2019 11/06/2019
01-19-89, 02-19-83, 03-19-82, 08-19-91, 09-19-85, 11-19-82, 14-19-81, 24-19-83, 27-19-83, 30-19-81, 31-19-88, 32-19-81, 33-19-85 OMAP Prior Authorization of Skeletal Muscle Relaxants – Pharmacy Services 10/31/2019 01/01/2020
01-19-91, 02-19-85, 03-19-84, 08-19-93, 09-19-87, 11-19-84, 14-19-83, 24-19-85, 27-19-85, 30-19-83, 31-19-90, 32-19-83, 33-19-87 OMAP Prior Authorization of Tetracyclines – Pharmacy Services 10/31/2019 01/01/2020
01-19-69, 02-19-63, 03-19-62, 08-19-71, 09-19-65, 11-19-62, 14-19-61, 24-19-63, 27-19-63, 30-19-61, 31-19-68, 32-19-61, 33-19-65 OMAP Prior Authorization of Pancreatic Enzymes – Pharmacy Services 10/31/2019 01/01/2020
01-19-66, 02-19-60, 03-19-59, 08-19-68, 09-19-62, 11-19-59, 14-19-58, 24-19-60, 27-19-60, 30-19-58, 31-19-65, 32-19-58, 33-19-62 OMAP Prior Authorization of Otic Antibiotics (Formerly Otic Antibiotic Preparations) – Pharmacy Services 10/30/2019 01/01/2020
01-19-90, 02-19-84, 03-19-83, 08-19-92, 09-19-86, 11-19-83, 14-19-82, 24-19-84, 27-19-84, 30-19-82, 31-19-89, 32-19-82. 33-19-86 OMAP Prior Authorization of Steroids, Topical (Formerly Steroids, Topical Low; Steroids, Topical Medium;Steroids, Topical High; and Steroids, Topical Very High) – Pharmacy Services 10/30/2019 01/01/2020
01-19-93, 02-19-87, 03-19-86, 08-19-95, 09-19-89, 11-19-86, 14-19-85, 24-19-87, 27-19-87, 30-19-85, 31-19-92, 32-19-85, 33-19-89 OMAP Prior Authorization of Proton Pump Inhibitors (PPIs) - Pharmacy Services 10/30/2019 01/01/2020
27-19-17 OMAP Medical Assistance Program Dental Fee Schedule and Dental Provider Handbook Update 10/30/2019 08/19/2019
01-19-92, 02-19-86, 03-19-85, 08-19-94, 09-19-88, 11-19-85, 14-19-84, 24-19-86, 27-19-86, 30-19-84, 31-19-91, 32-19-84, 33-19-88 OMAP Prior Authorization of Prenatal Vitamins – Pharmacy Services 10/30/2019 01/01/2020
01-19-80, 02-19-74, 03-19-73, 08-19-82, 09-19-76, 11-19-73, 14-19-72, 24-19-74, 27-19-74, 30-19-72, 31-19-79, 32-19-72, 33-19-76 OMAP Prior Authorization of Iron, Parenteral – Pharmacy Services 10/28/2019 01/01/2020
01-19-71, 02-19-65, 03-19-64, 08-19-73, 09-19-67, 11-19-64, 14-19-63, 24-19-65, 27-19-65, 30-19-63, 31-19-70, 32-19-63, 33-19-67 OMAP Prior Authorization of Ophthalmics, Antibiotics (Formerly Ophthalmic Antibiotics) – Pharmacy Services 10/28/2019 01/01/2020
01-19-95, 02-19-89, 03-19-88, 08-19-97, 09-19-91, 11-19-88, 14-19-87, 24-19-89, 27-19-89, 30-19-87, 31-19-94, 32-19-87, 33-19-91 OMAP Prior Authorization of Iron, Oral – Pharmacy Services 10/28/2019 01/01/2020
01-19-73, 02-19-67, 03-19-66, 08-19-75, 09-19-69, 11-19-66, 14-19-65, 24-19-67, 27-19-67, 30-19-65, 31-19-72, 32-19-65, 33-19-69 OMAP Prior Authorization of Neuropathic Pain Agents – Pharmacy Services 10/28/2019 01/01/2020
01-19-70, 02-19-64,03-19-63, 08-19-72, 09-19-66, 11-19-63, 14-19-62, 24-19-64, 27-19-64, 30-19-62, 31-19-69, 32-19-62, 33-19-66 OMAP Prior Authorization of Ophthalmics, Antibiotic-Steroid Combinations (Formerly Ophthalmic Antibiotic-Steroid Combinations) – Pharmacy Services 10/28/2019 01/01/2020
01-19-72, 02-19-66, 03-19-65, 08-19-74, 09-19-68, 11-19-64, 14-19-64, 24-19-66, 27-19-66, 30-19-64, 31-19-71, 32-19-64, 33-19-68 OMAP Prior Authorization of Ophthalmics, Allergic Conjunctivitis (Formerly Ophthalmic Agents for Allergic Conjunctivitis) – Pharmacy Services 10/25/2019 01/01/2020
01-19-68, 02-19-62, 03-19-61, 08-19-70, 09-19-64, 11-19-61, 14-19-60, 24-19-62, 27-19-62, 30-19-60, 31-19-67, 32-19-60, 33-19-64 OMAP Prior Authorization of Ophthalmics, Immunomodulators (Formerly Ophthalmic Immunomodulators) – Pharmacy Services 10/25/2019 01/01/2020
01-19-74, 02-19-68, 03-19-67, 08-19-76, 09-19-70, 11-19-67, 14-19-66, 24-19-68, 27-19-68, 30-19-66, 31-19-73, 32-19-66, 33-19-70 OMAP Prior Authorization of Macrolides (Formerly Macrolides/Ketolides) – Pharmacy Services 10/25/2019 01/01/2020
01-19-75, 02-19-69, 03-19-68, 08-19-77, 09-19-71, 11-19-68, 14-19-67, 24-19-69, 27-19-69, 30-19-67, 31-19-74, 32-19-67, 33-19-71 OMAP Prior Authorization of Ophthalmics, Glaucoma (Formerly Ophthalmic Agents for Glaucoma) – Pharmacy Services 10/25/2019 01/01/2020
01-19-67, 02-19-61, 03-19-60, 08-19-69, 09-19-63, 11-19-60, 14-19-59, 24-19-61, 27-19-61, 30-19-59, 31-19-66, 32-19-59, 33-19-63 OMAP Prior Authorization of Opioid Overdose Agents (Formerly Opiate Overdose Agents) – Pharmacy Services 10/25/2019 01/01/2020
01-19-76, 02-19-70, 03-19-69, 08-19-78, 09-19-72, 11-19-69, 14-19-68, 24-19-70, 27-19-70, 30-19-68, 31-19-75, 32-19-68, 33-19-72 OMAP Prior Authorization of Immunosuppressives, Oral – Pharmacy Services 10/21/2019 01/01/2020
01-19-77, 02-19-71, 03-19-70, 08-19-79, 09-19-73, 11-19-70, 14-19-69, 24-19-71, 27-19-71, 30-19-69, 31-19-76, 32-19-69, 33-19-73 OMAP Prior Authorization of Idiopathic Pulmonary Fibrosis (IPF) Agents – Pharmacy Services 10/21/2019 01/01/2020
01-19-81, 02-19-75, 03-19-74, 08-19-83, 09-19-77, 11-19-74, 14-19-73, 24-19-75, 27-19-75, 30-19-73, 31-19-80, 32-19-73, 33-19-77 OMAP Prior Authorization of Intra-Articular Hyaluronates – Pharmacy Services 10/21/2019 01/01/2020
01-19-78, 02-19-72, 03-19-71, 08-19-80, 09-19-74, 11-19-71, 14-19-70, 24-19-72, 27-19-72, 30-19-70, 31-19-77, 32-19-70, 33-19-74 OMAP Prior Authorization of Growth Factors – Pharmacy Services 10/18/2019 01/01/2020
01-19-96, 02-19-90, 03-19-89, 08-19-98, 09-19-92, 11-19-89, 14-19-88, 24-19-90, 27-19-90, 30-19-88, 31-19-95, 32-19-88, 33-19-92 OMAP Prior Authorization of Histamine 2 (H2) Receptor Blockers – Pharmacy Services 10/18/2019 01/01/2020
01-19-88, 02-19-82, 03-19-81, 08-19-90, 09-19-84, 11-19-81, 14-19-80, 24-19-82, 27-19-82, 30-19-80, 31-19-87, 32-19-80, 33-19-84 OMAP Prior Authorization of Antiemetic/Antivertigo Agents – Pharmacy Services 10/17/2019 01/01/2020
01-19-87, 02-19-81, 03-19-80, 08-19-89, 09-19-83, 11-19-80, 14-19-79, 24-19-81, 27-19-81, 30-19-79, 31-19-86, 32-19-79, 33-19-83 OMAP Prior Authorization of Acne Agents, Topical – Pharmacy Services 10/17/2019 01/01/2020
01-19-85, 02-19-79, 03-19-78, 08-19-87, 09-19-81, 11-19-78, 14-19-77, 24-19-79, 27-19-79, 30-19-77, 31-19-84, 32-19-77, 33-19-81 OMAP Prior Authorization of Antidepressants, SSRIs – Pharmacy Services 10/17/2019 01/01/2020
01-19-82, 02-19-76, 03-19-75, 08-19-84, 09-19-78, 11-19-75, 14-19-74, 24-19-76, 27-19-76, 30-19-74, 31-19-81, 32-19-74, 33-19-78 OMAP Prior Authorization of Antifungals, Oral – Pharmacy Services 10/17/2019 01/01/2020
01-19-97, 02-19-91, 03-19-90, 08-19-99, 09-19-93, 11-19-90, 14-19-89, 24-19-91, 27-19-91, 30-19-89, 31-19-96, 32-19-89, 33-19-93 OMAP Prior Authorization of BPH Treatments – Pharmacy Services 10/17/2019 01/01/2020
01-19-83, 02-19-77, 03-19-76, 08-19-85, 09-19-79, 11-19-76, 14-19-75, 24-19-77, 27-19-77, 30-19-75, 31-19-82, 32-19-75, 33-19-79 OMAP Prior Authorization of Fluoroquinolones, Oral – Pharmacy Services 10/16/2019 01/01/2020
01-19-86, 02-19-80, 03-19-79, 08-19-88, 09-19-82, 11-19-79, 14-19-78, 24-19-80, 27-19-80, 30-19-78, 31-19-85, 32-19-78, 33-19-82 OMAP Prior Authorization of Anticonvulsants – Pharmacy Services 10/16/2019 01/01/2020
01-19-84, 02-19-78, 03-19-77, 08-19-86, 09-19-80, 11-19-77, 14-19-76, 24-19-78, 27-19-78, 30-19-76, 31-19-83, 32-19-76, 33-19-80 OMAP Prior Authorization of Blood Glucose Meters and Test Strips (Formerly Diabetic Meters and Diabetic Strips) – Pharmacy Services 10/16/2019 01/01/2020
01-19-94, 02-19-88, 03-19-87, 08-19-96, 09-19-90, 11-19-87, 14-19-86, 24-19-88, 27-19-88, 30-19-86, 31-19-93, 32-19-86, 33-19-90 OMAP Prior Authorization of Antimigraine Agents, Triptans – Pharmacy Services 10/16/2019 01/01/2020
01-19-79, 02-19-73, 03-19-72, 08-19-81, 09-19-75, 11-19-72, 14-19-71, 24-19-73, 27-19-73, 30-19-71, 31-19-78, 32-19-71, 33-19-75 OMAP Prior Authorization of Glucocorticoids, Inhaled – Pharmacy Services 10/16/2019 01/01/2020
01-19-65, 02-19-59, 03-19-58, 08-19-67, 09-19-61, 11-19-58, 14-19-57, 24-19-59, 27-19-59, 30-19-57, 31-19-64, 32-19-57, 33-19-61 OMAP Statewide Preferred Drug List (PDL) Implementation – Pharmacy Services 10/10/2019 01/01/2020
01-19-21, 02-19-16, 08-19-22, 31-19-21 OMAP Updates to Sterilization Consent Form (MA 31) 09/27/2019 09/27/2019
35-19-01 OMAP School-Based ACCESS Program Provider Handbook 09/19/2019 09/19/2019
01-19-63, 02-19-57, 03-19-56, 08-19-65, 09-19-59, 11-19-56, 14-19-55, 24-19-57, 27-19-57, 30-19-55, 31-19-62, 32-19-55, 33-19-59 OMAP Prior Authorization of Hypoglycemics, Meglitinides – Pharmacy Services 09/16/2019 01/01/2020
01-19-47, 02-19-41, 03-19-40, 08-19-49, 09-19-43, 11-19-40, 14-19-39, 24-19-41, 27-19-41, 30-19-39, 31-19-46, 32-19-39, 33-19-43 OMAP Prior Authorization of Potassium Removing Agents – Pharmacy Services 09/11/2019 01/01/2020
01-19-64, 02-19-58,03-19-57,08-19-66, 09-19-60, 11-19-57, 14-19-56, 24-19-58, 27-19-58, 30-19-56, 31-19-63, 32-19-56, 33-19-60 OMAP Prior Authorization of Stimulants and Related Agents – Pharmacy Services 09/11/2019 01/01/2020
01-19-56, 02-19-50, 03-19-49, 08-19-58, 09-19-52, 11-19-49, 14-19-48, 24-19-50, 27-19-50, 30-19-48, 31-19-55, 32-19-48, 33-19-52 OMAP Prior Authorization of Ophthalmics, Anti-Inflammatories – Pharmacy Services 09/10/2019 01/01/2020
01-19-48, 02-19-42, 03-19-41, 08-19-50, 09-19-44, 11-19-41, 14-19-40, 24-19-42, 27-19-42, 30-19-40, 31-19-47, 32-19-40, 33-19-44 OMAP Prior Authorization of Ulcerative Colitis Agents – Pharmacy Services 09/10/2019 01/01/2020
01-19-57, 02-19-51, 03-19-50, 08-19-59, 09-19-53, 11-19-50, 14-19-49, 24-19-51, 27-19-51, 30-19-49, 31-19-56, 32-19-49, 33-19-53 OMAP Prior Authorization of Urea Cycle Disorder Agents – Pharmacy Services 09/10/2019 01/01/2020
01-19-55, 02-19-49, 03-19-48, 08-19-57, 09-19-51, 11-19-48, 14-19-47, 24-19-49, 27-19-49, 30-19-47, 31-19-54, 32-19-47, 33-19-51 OMAP Prior Authorization of Sedative Hypnotics – Pharmacy Services 09/10/2019 01/01/2020
01-19-60, 02-19-54, 03-19-53, 08-19-62, 09-19-56, 11-19-53, 14-19-52, 24-19-54, 27-19-54, 30-19-52, 31-19-59, 32-19-52, 33-19-56 OMAP Prior Authorization of Multiple Sclerosis Agents – Pharmacy Services 09/05/2019 01/01/2020
01-19-61, 02-19-55, 03-19-54, 08-19-63, 09-19-57, 11-19-54, 14-19-53, 24-19-55, 27-19-55, 30-19-53, 31-19-60, 32-19-53, 33-19-57 OMAP Prior Authorization of Iron Chelating Agents – Pharmacy Services 09/05/2019 01/01/2020
01-19-59, 02-19-53, 03-19-52, 08-19-61, 09-19-55, 11-19-52, 14-19-51, 24-19-53, 27-19-53, 30-19-51, 31-19-58, 32-19-51, 33-19-55 OMAP Prior Authorization of Oncology Agents, Breast Cancer – Pharmacy Services 09/05/2019 01/01/2020
01-19-54, 02-19-48, 03-19-47, 08-19-56, 09-19-50, 11-19-47, 14-19-46, 24-19-48, 27-19-48, 30-19-46, 31-19-53, 32-19-46, 33-19-50 OMAP Prior Authorization of Estrogens – Pharmacy Services 09/04/2019 01/01/2020
01-19-58, 02-19-52, 03-19-51, 08-19-60, 09-19-54, 11-19-51, 14-19-50, 24-19-52, 27-19-52, 30-19-50, 31-19-57, 32-19-50, 33-19-54 OMAP Prior Authorization of GI Motility, Chronic Agents – Pharmacy Services 09/04/2019 01/01/2020
01-19-53, 02-19-47, 03-19-46, 08-19-55, 09-19-49, 11-19-46, 14-19-45, 24-19-47, 27-19-47, 30-19-45, 31-19-52, 32-19-45, 33-19-49 OMAP Prior Authorization of Anticoagulants – Pharmacy Services 09/04/2019 01/01/2020
01-19-49, 02-19-43, 03-19-42, 08-19-51, 09-19-45, 11-19-42, 14-19-41, 24-19-43, 27-19-43, 30-19-41, 31-19-48, 32-19-41, 33-19-45 OMAP Prior Authorization of Bronchodilators, Beta Agonists – Pharmacy Services 09/04/2019 01/01/2020
01-19-62, 02-19-56, 03-19-55, 08-19-64, 09-19-58, 11-19-55, 14-19-54, 24-19-56, 27-19-56, 30-19-54, 31-19-61, 32-19-54, 33-19-58 OMAP Prior Authorization of Intranasal Rhinitis Agents – Pharmacy Services 09/03/2019 01/01/2020
01-19-52, 02-19-46, 03-19-45, 08-19-54, 09-19-48, 11-19-45, 14-19-44, 24-19-46, 27-19-46, 30-19-44, 31-19-51, 32-19-44, 33-19-48 OMAP Prior Authorization of Antihemophilia Agents – Pharmacy Services 09/03/2019 01/01/2020
01-19-50, 02-19-44, 03-19-43, 08-19-52, 09-19-46, 11-19-43, 14-19-42, 24-19-44, 27-19-44, 30-19-42, 31-19-49, 32-19-42, 33-19-46 OMAP Prior Authorization of Antihyperuricemics – Pharmacy Services 09/03/2019 01/01/2020
01-19-51, 02-19-45, 03-19-44, 08-19-53, 09-19-47, 11-19-44, 14-19-43, 24-19-45, 27-19-45, 30-19-43, 31-19-50, 32-19-43, 33-19-47 OMAP Prior Authorization of Antihistamines, Minimally Sedating – Pharmacy Services 09/03/2019 01/01/2020
01-19-13, 08-19-15, 09-19-13, 24-19-10, 25-19-01, 28-19-02, 31-19-13, 33-19-13 OMAP Family Planning Services Program 08/23/2019 08/19/2019
99-19-06 OMAP Corrected - Diabetes Prevention Program Enrollment in the Medical Assistance Program 08/22/2019 07/01/2019
01-19-31, 02-19-26, 03-19-25, 08-19-34, 09-19-29, 11-19-25, 14-19-25, 24-19-27, 27-19-27, 30-19-25, 31-19-31, 32-19-25, 33-19-29 OMAP Prior Authorization of Urinary Anti-Infectives – Pharmacy Services 08/21/2019 01/01/2020
01-19-41, 02-19-36, 03-19-35, 08-19-44, 09-19-39, 11-19-35, 14-19-35, 21-19-37, 27-19-37, 30-19-35, 31-19-41, 32-19-35, 33-19-39 OMAP Prior Authorization of Thrombopoietics – Pharmacy Services 08/21/2019 01/01/2020
01-19-29, 02-19-24, 03-19-23, 08-19-32, 09-19-27, 11-19-23, 14-19-23, 24-19-25, 27-19-25, 30-19-23, 31-19-29, 32-19-23, 33-19-27 OMAP Prior Authorization of Vitamin D Analogs – Pharmacy Services 08/21/2019 01/01/2020
01-19-30, 02-19-25, 03-19-24, 08-19-33, 09-19-28, 11-19-24, 14-19-24, 24-19-26, 27-19-26, 30-19-24, 31-19-30, 32-19-24, 33-19-28 OMAP Prior Authorization of Vaginal Anti-Infectives – Pharmacy Services 08/21/2019 01/01/2020
01-19-43, 02-19-38, 03-19-37, 08-19-46, 09-19-41, 11-19-37, 14-19-37, 24-19-39, 27-19-39, 30-19-37, 31-19-43, 32-19-37, 33-19-41 OMAP Prior Authorization of Antipsychotics – Pharmacy Services 08/21/2019 01/01/2020
01-19-42, 02-19-37, 03-19-36, 08-19-45, 09-19-40, 11-19-36, 14-19-36, 24-19-38, 27-19-38, 30-19-36, 31-19-19, 32-19-36, 33-19-40 OMAP Prior Authorization of COPD Agents – Pharmacy Services 08/21/2019 01/01/2020
01-19-33, 02-19-28, 03-19-27, 08-19-36, 09-19-31, 11-19-27, 14-19-27, 24-19-29, 27-19-29, 30-19-27, 31-19-33, 32-19-27, 33-19-31 OMAP Prior Authorization of Antivirals, Influenza - Pharmacy Services 08/20/2019 01/01/2020
01-19-36, 02-19-31, 03-19-30, 08-19-39, 09-19-34, 11-19-30, 14-19-30, 24-19-32, 27-19-32, 30-19-30, 31-19-36, 32-19-30, 33-19-34 OMAP Prior Authorization of Antivirals, CMV - Pharmacy Services 08/20/2019 01/01/2020
01-19-44, 02-19-39, 03-19-38, 08-19-47, 09-19-42, 11-19-38, 14-19-38, 24-19-40, 27-19-40, 30-19-38, 31-19-44, 32-19-38, 33-19-42 OMAP Prior Authorization of H. Pylori Treatments – Pharmacy Services 08/20/2019 01/01/2020
01-19-35, 09-19-33, 27-19-31, 33-19-33,02-19-30, 11-19-29, 30-19-29,03-19-29, 14-19-29, 31-19-35,08-19-38, 24-19-31, 32-19-29 OMAP Prior Authorization of Antivirals, Herpes – Pharmacy Services 08/20/2019 01/01/2020
01-19-32, 02-19-27, 03-19-26, 08-19-35, 09-19-30, 11-19-26, 14-19-26, 24-19-28, 27-19-28, 30-19-26, 31-19-32, 32-19-26, 33-19-30 OMAP Prior Authorization of Bone Density Regulators – Pharmacy Services 08/20/2019 01/01/2020
99-19-04 OMAP 2019 Healthcare Common Procedure Coding System(HCPCS) Updates, Fee Adjustments and Other Procedure Code Changes 08/19/2019 08/19/2019
99-19-02 OMAP Pennsylvania’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program Peridicity Schedule 08/19/2019 08/19/2019
01-19-23, 02-19-18, 03-19-17, 08-19-26, 09-19-21, 11-19-17, 14-19-17, 24-19-19, 27-19-19, 30-19-17, 31-19-23, 32-19-17, 33-19-21 OMAP Prior Authorization of Penicillins – Pharmacy Services 08/08/2019 01/01/2020
01-19-25, 09-19-23, 27-19-21, 33-19-23, 02-19-20,11-19-19, 30-19-19, 03-19-19, 14-19-19, 31-19-25,08-19-28 24-19-21 32-19-19 OMAP Prior Authorization of Local Anesthetics, Topical – Pharmacy Services 08/08/2019 01/01/2020
01-19-28, 02-19-23, 03-19-22, 08-19-31, 09-19-26, 11-19-22, 14-19-22, 24-19-24, 27-19-24, 30-19-22, 31-19-28, 32-19-22, 33-19-26 OMAP Prior Authorization of Cephalosporins – Pharmacy Services 08/08/2019 01/01/2020
01-19-24, 02-19-19, 03-19-18, 08-19-27, 09-19-22, 11-19-18, 14-19-18, 24-19-20, 27-19-20, 30-19-18, 31-19-24, 32-19-18, 33-19-22 OMAP Prior Authorization of Monoclonal Antibodies - Anti-IL, Anti-IgE (MABs - Anti-IL, Anti-IgE) - Pharmacy Services 08/08/2019 01/01/2020
01-19-26, 02-19-21, 03-19-20, 08-19-29, 09-19-24, 11-19-20, 14-19-20, 24-19-22, 27-19-22, 30-19-20, 31-19-26, 32-19-20, 33-19-24 OMAP Prior Authorization of HIV/AIDS Antiretrovirals - Pharmacy Services 08/08/2019 01/01/2020
01-19-22, 02-19-17, 03-19-16, 08-19-25, 09-19-20, 11-19-16, 14-19-16, 24-19-18, 27-19-18, 30-19-16, 31-19-22, 32-19-16, 33-19-20 OMAP Prior Authorization of Thalidomide and Derivatives – Pharmacy Services 08/08/2019 01/01/2020
01-19-27, 02-19-22, 03-19-21, 08-19-30, 09-19-25, 11-19-21, 14-19-21, 24-19-23, 27-19-23, 30-19-21, 31-19-27, 32-19-21, 33-19-25 OMAP Prior Authorization of Colony Stimulating Factors - Pharmacy Services 08/08/2019 01/01/2020
OMHSAS-19-03 OMHSAS Serious Mental Illness: Adult Priority Group 08/06/2019 08/06/2019
00-19-12 OCYF Notification Protocol for Formal Licensing Actions and Incidents 08/02/2019 08/02/2019
01-19-40, 02-19-35, 03-19-34, 08-19-43, 09-19-38, 11-19-34, 14-19-34, 24-19-36, 27-19-36, 30-19-34, 31-19-40, 32-19-34, 33-19-38 OMAP Prior Authorization of Angiotensin Modulators - Pharmacy Services 07/31/2019 01/01/2020
01-19-38, 09-19-36, 27-19-34, 33-19-36, 02-19-33, 11-19-32, 30-19-32, 03-19-32, 14-19-32, 31-19-38, 08-19-41, 24-19-34, 32-19-32 OMAP Prior Authorization of Antimalarials – Pharmacy Services 07/31/2019 01/01/2020
01-19-39, 02-19-34, 03-19-33, 08-19-42, 09-19-37, 11-19-33, 14-19-33, 24-19-35, 27-19-35, 30-19-33, 31-19-39, 32-19-33, 33-19-37 OMAP Prior Authorization of Antianginal Agents – Pharmacy Services 07/31/2019 01/01/2020
01-19-34, 02-19-29, 03-19-28, 08-19-37, 09-19-32, 11-19-28, 14-19-28, 24-19-30, 27-19-30, 30-19-28, 31-19-34, 32-19-28, 33-19-32 OMAP Prior Authorization of Acne Agents, Oral – Pharmacy Services 07/30/2019 01/01/2020
01-19-37, 02-19-32, 03-19-31, 08-19-40, 09-19-35, 11-19-31, 14-19-31, 24-19-33, 27-19-33, 30-19-31, 31-19-37, 32-19-31, 33-19-35 OMAP Prior Authorization of Antimigraine Agents, Other – Pharmacy Services 07/30/2019 01/01/2020
OMHSAS-19-02 OMHSAS Service Location Enrollment for Behavioral Health Providers 07/30/2019 10/01/2019
00-19-03 ODP Prioritization of Urgency of Need for Services (PUNS) Manual 07/23/2019 07/23/2019
01-19-46, 08-19-48, 11-19-39, 19-19-01, 21-19-01, 31-19-45 OMAP Certified Recovery Specialists in Centers of Excellence 07/17/2019 07/17/2019
01-19-45, 02-19-40, 03-19-39, 05-19-03, 06-19-01, 34-19-01, 47-19-02, 56-19-01 OMAP Medical Marijuana and State Licensure of Facilities and Agencies 07/17/2019 07/17/2019
99-19-03 OMAP Diabetes Prevention Program Enrollment in the Medical Assistance Program 07/02/2019 07/01/2019
00-19-02 ODP OVR Referrals During a Period when OVR’s Order of Selection is Closed 07/01/2019 07/01/2019
01-19-16, 02-19-11, 03-19-11, 08-19-17, 09-19-15, 11-19-11, 14-19-11, 24-19-13, 27-19-12, 30-19-11, 31-19-16, 32-19-11, 33-19-15 OMAP Prior Authorization of Dupixent (dupilumab) – Pharmacy Services 06/27/2019 07/08/2019
01-19-15, 02-19-10, 03-19-10, 08-19-16, 09-19-14, 11-19-10, 14-19-10, 24-19-12, 27-19-11, 30-19-10, 31-19-15, 32-19-10, 33-19-14 OMAP Prior Authorization of Antibiotics, Inhaled – Pharmacy Services 06/27/2019 07/08/2019
01-19-18, 02-19-13, 03-19-13, 08-19-19, 09-19-17, 11-19-13, 14-19-13, 24-19-15, 27-19-14, 30-19-13, 31-19-18, 32-19-13, 33-19-17 OMAP Prior Authorization of Xyrem (sodium oxybate) – Pharmacy Services 06/27/2019 07/08/2019
01-19-19, 02-19-14, 03-19-14, 08-19-20, 09-19-18, 11-19-14, 14-19-14, 24-19-16, 27-19-15, 30-19-14, 31-19-19, 32-19-14, 33-19-18 OMAP Prior Authorization of Complement Inhibitors – Pharmacy Services 06/27/2019 07/08/2019
01-19-20, 02-19-15, 03-19-15, 08-19-21, 09-19-19, 11-19-15, 14-19-15, 24-19-17, 27-19-16, 30-19-15, 31-19-20, 32-19-15, 33-19-19 OMAP Prior Authorization of Calcium Channel Blockers – Pharmacy Services 06/27/2019 07/08/2019
01-19-17, 02-19-12, 03-19-12, 08-19-18, 09-19-16, 11-19-12, 14-19-12, 24-19-14, 27-19-13, 30-19-12, 31-19-17, 32-19-12, 33-19-16 OMAP Prior Authorization of Immunomodulators, Atopic Dermatitis – Pharmacy Services 06/27/2019 07/08/2019
99-19-01 OMAP 2019 Recommended Childhood and Adolescent Immunization Schedule 04/22/2019 04/22/2019
01-19-11, 08-19-13, 09-19-11, 31-19-11, 33-19-11 OMAP Update to the Administration of the Human Papillomavirus (HPV) Vaccine 04/05/2019 10/05/2018
IEB-19-04, IAE-19-04, 07-19-04 OLTL Implementation of the Functional Eligibility Determination Process 04/01/2019 04/01/2019
OMHSAS-19-01 OMHSAS Admissions, Discharges and Continuity of Care for State Mental Hospitals 03/20/2019 03/20/2019
01-19-12, 05-19-01, 08-19-14, 09-19-12, 31-19-12, 33-19-12, 47-19-01 OMAP Changes to Third-Party Liability Requirements for Claims for Prenatal Services 03/01/2019 04/01/2019
00-19-01 ODP OVR Referrals for ODP Employment Related Services 02/14/2019 02/15/2019
54-19-02, 59-19-02 OLTL Act 150 Program Sliding Fee Scale for Calendar Year 2019 02/11/2019 01/01/2019
59-19-03 OLTL Hearings and Appeals 02/11/2019 02/11/2019
59-19-01 OLTL Standardized Physician Certification Form 01/29/2019 02/01/2019
01-19-02, 02-19-01, 03-19-01, 08-19-03, 09-19-02, 11-19-01, 14-19-01, 24-19-01, 27-19-01, 30-19-01, 31-19-02, 32-19-01, 33-19-02 OMAP Prior Authorization of Symdeko (tezacaftor/ivacaftor) – Pharmacy Services 01/21/2019 01/22/2019
01-19-03, 02-19-02, 03-19-02, 08-19-04, 09-19-03, 11-19-02, 14-19-02, 24-19-02, 27-19-02, 30-19-02, 31-19-03, 32-19-02, 33-19-03 OMAP Prior Authorization of Radicava (edaravone) – Pharmacy Services 01/21/2019 01/22/2019
01-19-04, 02-19-03, 03-19-03, 08-19-06, 09-19-04, 11-19-03, 14-19-03, 24-19-03, 27-19-04, 30-19-03, 31-19-04, 32-19-03, 33-19-04 OMAP Preferred Drug List (PDL) Update January 28, 2019 - Pharmacy Services 01/18/2019 01/28/2019
01-19-06, 02-19-05, 03-19-05, 08-19-08, 09-19-06, 11-19-05, 14-19-05, 24-19-05, 27-19-06, 30-19-05, 31-19-06, 32-19-05, 33-19-06 OMAP Prior Authorization of Anticonvulsants - Pharmacy Services 01/18/2019 01/28/2019
01-19-10, 02-19-09, 03-19-09, 08-19-12, 09-19-10, 11-19-09, 14-19-09, 24-19-09, 27-19-10, 30-19-09, 31-19-10, 32-19-09, 33-19-10 OMAP Prior Authorization of Multiple Sclerosis Agents – Pharmacy Services 01/18/2019 01/28/2019
01-19-08, 02-19-07, 03-19-07, 08-19-10, 09-19-08, 11-19-07, 14-19-07, 24-19-07, 27-19-08, 30-19-07, 31-19-08, 32-19-07, 33-19-08 OMAP Prior Authorization of Alpha-1 Proteinase Inhibitors – Pharmacy Services 01/18/2019 01/28/2019
01-19-07, 02-19-06, 03-19-06, 08-19-09, 09-19-07, 11-19-06, 14-19-06, 24-19-06, 27-19-07, 30-19-06, 31-19-07, 32-19-06, 33-19-07 OMAP Prior Authorization of Pulmonary Arterial Hypertension (PAH) Agents, Oral and Inhaled – Pharmacy Services 01/18/2019 01/28/2019
01-19-09, 02-19-08, 03-19-08, 08-19-11, 09-19-09, 11-19-08, 14-19-08, 24-19-08, 27-19-09, 30-19-08, 31-19-09, 32-19-08, 33-19-09 OMAP Prior Authorization of Antiparkinson’s Agents – Pharmacy Services 01/18/2019 01/28/2019
01-19-05, 02-19-04, 03-19-04, 08-19-07, 09-19-05, 11-19-04, 14-19-04, 24-19-04, 27-19-05, 30-19-04, 31-19-05, 32-19-04, 33-19-05 OMAP Prior Authorization of Antihyperuricemics – Pharmacy Services 01/18/2019 01/28/2019
01-19-01, 08-19-01, 09-19-01, 28-19-01, 31-19-01, 33-19-01 OMAP Updates to Laboratory Services on the Medical Assistance Program Fee Schedule; Prior Authorization for Noninvasive Prenatal Screening (NiPS) 01/02/2019 01/14/2019
26-18-01 OMAP Fee Increases for Certain Ambulance Transportation Services 12/24/2018 01/01/2019
99-18-11 OMAP Service Location Enrollment Deadline 12/19/2018 12/19/2018
01-18-34, 02-18-29, 03-18-30, 08-18-37, 09-18-35, 11-18-29, 14-18-30, 24-18-31, 27-18-34, 30-18-29, 31-18-35, 32-18-29, 33-18-34 OMAP Prior Authorization of Oncology Agents, Oral – Pharmacy Services 12/13/2018 12/17/2018
01-18-32, 02-18-27, 03-18-28, 08-18-35, 09-18-33, 11-18-27, 14-18-28, 24-18-29, 27-18-32, 30-18-27, 31-18-33, 32-18-27, 33-18-32 OMAP Prior Authorization of Kalydeco (ivacaftor) – Pharmacy Services 12/13/2018 12/17/2018
01-18-35, 02-18-30, 03-18-31, 08-18-38, 09-18-36, 11-18-30, 14-18-31, 24-18-32, 27-18-35, 30-18-30, 31-18-36, 32-18-30, 33-18-35 OMAP Prior Authorization of Orkambi (lumacaftor/ivacaftor) – Pharmacy Services 12/13/2018 12/17/2018
01-18-29, 02-18-24, 03-18-25, 08-18-32, 09-18-30, 11-18-24, 14-18-25, 24-18-26, 27-18-29, 30-18-24, 31-18-30, 32-18-24, 33-18-29 OMAP Prior Authorization of Hypoglycemics, Incretin Mimetics/Enhancers – Pharmacy Services 12/13/2018 12/17/2018
01-18-30, 02-18-25, 03-18-26, 08-18-33, 09-18-31, 11-18-25, 14-18-26, 24-18-27, 27-18-30, 30-18-25, 31-18-31, 32-18-25, 33-18-30 OMAP Prior Authorization of Hypoglycemics, Insulin and Related Agents – Pharmacy Services 12/13/2018 12/17/2018
01-18-31, 02-18-26, 03-18-27, 08-18-34, 09-18-32, 11-18-26, 14-18-27, 24-18-28, 27-18-31, 30-18-26, 31-18-32, 32-18-26, 33-18-31 OMAP Prior Authorization of Hypoglycemics, SGLT2 Inhibitors – Pharmacy Services 12/13/2018 12/17/2018
01-18-33, 02-18-28, 03-18-29, 08-18-36, 09-18-34, 11-18-28, 14-18-29, 24-18-30, 27-18-33, 30-18-28, 31-18-34, 32-18-28, 33-18-33 OMAP Prior Authorization of Hypoglycemics, TZDs – Pharmacy Services 12/13/2018 12/17/2018
01-18-36, 09-18-37, 27-18-36, 33-18-36, 02-18-31, 11-18-31, 30-18-31, 03-18-32, 14-18-32, 31-18-37, 08-18-39, 24-18-33, 32-18-31 OMAP Prior Authorization of Antibiotics, GI and Related Agents – Pharmacy Services 12/12/2018 12/17/2018
01-18-27, 09-18-28, 27-18-27, 33-18-27, 02-18-22, 11-18-22, 30-18-22, 03-18-23, 14-18-23, 31-18-28, 08-18-30, 24-18-24, 32-18-22 OMAP Prior Authorization of Antimigraine Agents, Other – Pharmacy Services 12/12/2018 12/17/2018
01-18-26, 09-18-27, 27-18-26, 33-18-26, 02-18-21, 11-18-21, 30-18-21, 03-18-22, 14-18-22, 31-18-27, 08-18-29, 24-18-23, 32-18-21 OMAP Prior Authorization of Angiotensin Modulators – Pharmacy Services 12/12/2018 12/17/2018
01-18-25, 09-18-26, 27-18-25, 33-18-25, 02-18-20, 11-18-20, 30-18-20, 03-18-21, 14-18-21, 31-18-26, 08-18-28, 24-18-22, 32-18-20 OMAP Prior Authorization of Angiotensin Modulator Combinations – Pharmacy Services 12/12/2018 12/17/2018
01-18-28, 09-18-29, 27-18-28, 33-18-28, 02-18-23, 11-18-23, 30-18-23, 03-18-24, 14-18-24, 31-18-29, 08-18-31, 24-18-25, 32-18-23 OMAP Prior Authorization of Hepatitis C Agents – Pharmacy Services 12/12/2018 12/17/2018
03-18-20 OMAP Changes to Managed Care Coverage of Nursing Facility Services 11/21/2018 11/21/2018
2018-05 Maximum Rates of State Participation for Employee Benefits for County Children and Youth Agencies and Mental Health/Intellectual Disabilities/Early Intervention Programs 11/01/2018 07/01/2018
24-18-21 OMAP Professional Dispensing Fee - Pharmacy Services 10/04/2018 04/01/2017
35-18-02 OMAP School-Based ACCESS Program Provider Handbook 09/19/2018 09/19/2018
00-18-06 ODP Variance Form and Process: Requesting a Variance 09/17/2018 09/17/2018
59-18-06 OLTL Rescission of HCBS Directives, Bulletins and Other Policy Documents 09/17/2018 09/17/2018
00-18-05 ODP Fee Schedule Rates and Methodology for Waiver Services TSM and Base-Funded Program Services 09/13/2018 07/01/2017
03-18-05 OLTL Electronic Submission of the Cost Report (MA-11) Form for Reporting Periods Ending 12/31/18 and Thereafter 09/04/2018 01/01/2019
01-18-10, 08-18-11, 09-18-11, 31-18-11, 33-18-10, 55-18-01 OMAP Environmental Lead Investigations 08/22/2018 08/22/2018
01-18-24, 02-18-19, 03-18-19, 08-18-26, 09-18-25, 11-18-19, 14-18-20, 24-18-20, 27-18-23, 30-18-19, 31-18-25, 32-18-19, 33-18-24 OMAP Prior Authorization of Multiple Sclerosis Agents - Pharmacy Services 08/13/2018 08/13/2018
01-18-04, 03-18-04 OLTL Revised Pennsylvania Preadmission Screening Resident Review (PASRR) Level II Evaluation Form (MA 376.2) 08/01/2018 09/01/2018
01-18-03, 03-18-03, 07-18-03, 59-18-03 OLTL Revised Pennsylvania Preadmission Screening Resident Review (PASRR) Level I Identification Form (MA 376) 08/01/2018 09/01/2018
99-18-13 OMAP Updates to Pennsylvania’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program Periodicity Schedule 08/01/2018 08/01/2018
00-18-04 ODP Interim Technical Guidance for Claim and Service Documentation 07/25/2018 07/25/2018
00-18-03 ODP Health Care Quality Units 07/24/2018 07/24/2018
01-18-20, 09-18-21, 27-18-19, 33-18-20, 02-18-15, 11-18-15, 30-18-15, 03-18-15, 14-18-16, 31-18-21, 08-18-22, 24-18-16, 32-18-15 OMAP Prior Authorization of Enzyme Replacements, Gauchers Disease - Pharmacy Services 07/23/2018 07/23/2018
01-18-13, 02-18-08, 03-18-08, 08-18-15, 09-18-14, 11-18-08, 14-18-09, 24-18-09, 27-18-12, 30-18-08, 31-18-14, 32-18-08, 33-18-13 OMAP Prior Authorization of Immunomodulators, Atopic Dermatitis – Pharmacy Services 07/23/2018 07/23/2018
01-18-16, 02-18-11, 03-18-11, 08-18-18, 09-18-17, 11-18-11, 14-18-12, 24-18-12, 27-18-15, 30-18-11, 31-18-17, 32-18-11, 33-18-16 OMAP Prior Authorization of Neuropathic Pain Agents – Pharmacy Services 07/23/2018 07/23/2018
01-18-17, 02-18-12, 03-18-12, 08-18-19, 09-18-18, 11-18-12, 14-18-13, 24-18-13, 27-18-16, 30-18-12, 31-18-18, 32-18-12, 33-18-17 OMAP Prior Authorization of VMAT2 Inhibitors - Pharmacy Services 07/23/2018 07/23/2018
01-18-15, 02-18-10, 03-18-10, 08-18-17, 09-18-16, 11-18-10, 14-18-11, 24-18-11, 27-18-14, 30-18-10, 31-18-16, 32-18-10, 33-18-15 OMAP Prior Authorization of Monoclonal Antibodies - Anti-IL, Anti-IgE (MABs-Anti-IL, Anti-IgE) – Pharmacy Services 07/23/2018 07/23/2018
01-18-14, 02-18-09, 03-18-09, 08-18-16, 09-18-15, 11-18-09, 14-18-10, 24-18-10, 27-18-13, 30-18-09, 31-18-15, 32-18-09, 33-18-14 OMAP Prior Authorization of Lipotropics, Other – Pharmacy Services 07/23/2018 07/23/2018
01-18-21, 09-18-22, 27-18-20, 33-18-21, 02-18-16, 11-18-16, 30-18-16, 03-18-16, 14-18-17, 31-18-22, 08-18-23, 24-18-17, 32-18-16 OMAP Prior Authorization of Idiopathic Pulmonary Fibrosis (IPF) Agents - Pharmacy Services 07/23/2018 07/23/2018
01-18-18, 09-18-19, 27-18-17, 33-18-18, 02-18-13, 11-18-13, 30-18-13, 03-18-13, 14-18-14, 31-18-19, 08-18-20, 24-18-14, 32-18-13 OMAP Prior Authorization of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) – Pharmacy Services 07/23/2018 07/23/2018
01-18-23, 09-18-24, 27-18-22, 33-18-23, 02-18-18, 11-18-18, 30-18-18, 03-18-18, 14-18-19, 31-18-24, 08-18-25, 24-18-19, 32-18-18 OMAP Prior Authorization of Thalidomide and Derivatives - Pharmacy Services 07/23/2018 07/23/2018
01-18-22, 09-18-23, 27-18-21, 33-18-22, 02-18-17, 11-18-17, 30-18-17, 03-18-17, 14-18-18, 31-18-23, 08-18-24, 24-18-18, 32-18-17 OMAP Prior Authorization of Oncology Agents, Oral -Pharmacy Services 07/23/2018 07/23/2018
01-18-12, 02-18-07, 03-18-07, 08-18-14, 09-18-13, 11-18-07, 14-18-08, 24-18-08, 27-18-11, 30-18-07, 31-18-13, 32-18-07, 33-18-12 OMAP Prior Authorization of Analgesics, Non-Opioid Barbiturate Combinations – Pharmacy Services 07/23/2018 07/23/2018
01-18-19, 09-18-20, 27-18-18, 33-18-19, 02-18-14, 11-18-14, 30-18-14, 03-18-14, 14-18-15, 31-18-20, 08-18-21, 24-18-15, 32-18-14 OMAP Prior Authorization of Bone Resorption Suppression and Related Agents - Pharmacy Services 07/23/2018 07/23/2018
01-18-11, 09-18-12, 27-18-10, 02-18-06, 11-18-06, 30-18-06, 03-18-06, 14-18-07, 31-18-12, 08-18-13, 24-18-07, 32-18-06, 33-18-11 OMAP Preferred Drug List (PDL) Update July 23, 2018 - Pharmacy Services 07/18/2018 07/23/2018
27-18-09 OMAP Updates to the Pediatric Dental Periodicity Schedule 07/03/2018 07/03/2018
01-18-09, 08-18-10, 09-18-10, 16-18-01, 23-18-01, 31-18-10 OMAP Childhood Nutrition and Weight Management Services 07/03/2018 07/03/2018
01-18-08, 08-18-09, 09-18-09, 24-18-06, 25-18-01, 28-18-02, 31-18-09, 33-18-09 OMAP Updates to the Family Planning Services Program Fee Schedule 07/02/2018 07/02/2018
99-18-07 OMAP 2018 Healthcare Common Procedure Coding System (HCPCS) Updates and Other Procedure Code Changes 07/02/2018 07/02/2018
27-18-08 OMAP Medical Assistance Program Dental Fee Schedule Update 07/02/2018 07/02/2018
OMHSAS-18-01 OMHSAS CONSENT TO MENTAL HEALTH TREATMENT FOR MINOR CHILDREN 06/29/2018 07/05/2018
99-18-10 OMAP Enrollment of Tobacco Cessation Providers 06/18/2018 06/18/2018
99-18-09 OMAP Reduction of Mailed Paper Remittance Advices 06/15/2018 08/06/2018
99-18-08 OMAP Update to 180-Day Exception Requests and Invoice Submission Time Frames 05/25/2018 05/25/2018
00-18-02 ODP Home and Community-Based Services (HCBS) Eligibility/Ineligibility/Change Form (PA 1768) and Instructions 05/10/2018 05/10/2018
99-18-05 * OMAP 2018 Recommended Childhood and Adolescent Immunization Schedule 04/27/2018 04/27/2018
01-18-05, 09-18-06, 27-18-05, 33-18-06, 02-18-03, 11-18-03, 30-18-03, 03-18-03, 14-18-04, 31-18-06, 08-18-06, 24-18-03, 32-18-03 OMAP Prior Authorization of Analgesics, Opioid Short Acting – Pharmacy Services 04/26/2018 04/26/2018
01-18-07, 09-18-08, 27-18-07, 33-18-08, 02-18-05, 11-18-05, 30-18-05, 03-18-05, 14-18-06, 31-18-08, 08-18-08, 24-18-05, 32-18-05 OMAP Prior Authorization of Analgesics, Opioid Long Acting – Pharmacy Services 04/26/2018 04/26/2018
99-18-06 OMAP Update to Submission of Claims that Require the National Provider Identifier (NPI) of a Medical Assistance Enrolled Ordering, Referring or Prescribing Provider 04/16/2018 04/27/2018
00-18-01 ODP Guidelines Concerning Sexual Health, Personal Relationships, and Sexuality 04/13/2018 04/13/2018
01-18-06, 02-18-04, 03-18-04, 08-18-07, 09-18-07, 11-18-04, 14-18-05, 24-18-04, 27-18-06, 30-18-04, 31-18-07, 32-18-04, 33-18-07 OMAP Prior Authorization of Opioid Dependence Treatments – Pharmacy Services 04/10/2018 04/10/2018
35-18-01 OMAP School-Based ACCESS Program Provider Handbook 03/14/2018 03/14/2018
01-18-02, 08-18-02, 09-18-02, 31-18-02, 33-18-02 OMAP Addition to the Medical Assistance Program Fee Schedule for Administration of Quadrivalent Flu Vaccine Derived from Cell Cultures, Preservative 03/05/2018 03/05/2018
01-18-03, 08-18-03, 09-18-03, 27-18-02, 28-18-01, 31-18-03, 33-18-03 OMAP Clinical Laboratory Improvement Amendments Excluded Laboratory Services Update 02/26/2018 02/26/2018
08-18-05, 09-18-05,10-18-01,14-18-03, 27-18-04, 31-18-05, 33-18-05 OMAP Acupuncturist Enrollment in the Medical Assistance Program 02/21/2018 02/21/2018
01-18-04, 02-18-02, 03-18-02, 08-18-04, 09-18-04, 11-18-02, 14-18-02, 24-18-02, 27-18-03, 30-18-02, 31-18-04, 32-18-02, 33-18-04 OMAP Corrected - Prior Authorization of Hepatitis C Agents - Pharmacy Services 01/22/2018 01/01/2018
59-18-01 OLTL Standardized Participant Information Packet 01/16/2018 01/16/2018
01-18-01, 02-18-01, 03-18-01, 08-18-01, 09-18-01, 11-18-01, 14-18-01, 24-18-01, 27-18-01, 30-18-01, 31-18-01, 32-18-01, 33-18-01 OMAP Preferred Drug List (PDL) Update January 8, 2018- Pharmacy Services 01/08/2018 01/08/2018
99-18-02 OMAP Updates to the 2017 Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program Periodicity Schedule 01/03/2018 01/03/2018
99-18-01 OMAP Revised Health Care Benefit Packages Provider Reference Chart (MA 446) 01/02/2018 01/02/2018
54-17-02, 59-17-02 * OLTL Act 150 Program Sliding Fee Scale for Calendar Year 2018 01/02/2018 01/01/2018
01-17-36, 02-17-31, 03-17-31, 08-17-38, 09-17-35, 11-17-31, 14-17-32, 24-17-32, 27-17-33, 30-17-32, 31-17-37, 32-17-31, 33-17-36 OMAP Prior Authorization of Analgesics, Opioid Long Acting - Pharmacy Services 12/27/2017 01/08/2018
01-17-38, 02-17-33, 03-17-33, 08-17-40, 09-17-37, 11-17-33, 14-17-34, 24-17-34, 27-17-35, 30-17-34, 31-17-39, 32-17-33, 33-17-38 OMAP Prior Authorization of Multiple Sclerosis Agents - Pharmacy Services 12/27/2017 01/08/2018
01-17-40, 02-17-35, 03-17-35, 08-17-42, 09-17-39, 11-17-35, 14-17-36, 24-17-36, 27-17-37, 30-17-36, 31-17-41, 32-17-35, 33-17-40 OMAP Prior Authorization of Austedo (deutetrabenazine) - Pharmacy Services 12/27/2017 01/08/2018
01-17-45, 02-17-40, 03-17-40, 08-17-47, 09-17-44, 11-17-40, 14-17-41, 24-17-41, 27-17-42, 30-17-41, 31-17-46, 32-17-40, 33-17-45 OMAP Prior Authorization of Xenazine (tetrabenazine) - Pharmacy Services 12/27/2017 01/08/2018
01-17-46, 02-17-41, 03-17-41, 08-17-48, 09-17-45, 11-17-41, 14-17-42, 24-17-42, 27-17-43, 30-17-42, 31-17-47, 32-17-41, 33-17-46 OMAP Prior Authorization of Cytokine and CAM Antagonists - Pharmacy Services 12/27/2017 01/08/2018
01-17-39, 02-17-34, 03-17-34, 08-17-41, 09-17-38, 11-17-34, 14-17-35, 24-17-35, 27-17-36, 30-17-35, 31-17-40, 32-17-34, 33-17-39 OMAP Prior Authorization of Ingrezza (valbenazine) - Pharmacy Services 12/27/2017 01/08/2018
01-17-37, 02-17-32, 03-17-32, 08-17-39, 09-17-36, 11-17-32, 14-17-33, 24-17-33, 27-17-34, 30-17-33, 31-17-38, 32-17-32, 33-17-37 OMAP Prior Authorization of Analgesics, Opioid Short Acting - Pharmacy Services 12/27/2017 01/08/2018
01-17-03 OMAP Hospital Responsibilities Related to the Uncompensated Care Program and Charity Care Plans 12/27/2017 12/27/2017
01-17-44, 02-17-39, 03-17-39, 08-17-46, 09-17-43, 11-17-39, 14-17-40, 24-17-40, 27-17-41, 30-17-40, 31-17-45, 32-17-39, 33-17-44 OMAP Prior Authorization of Xermelo (telotristat ethyl) - Pharmacy Services 12/27/2017 01/08/2018
01-17-41, 02-17-36, 03-17-36, 08-17-43, 09-17-40, 11-17-36, 14-17-37, 24-17-37, 27-17-38, 30-17-37, 31-17-42, 32-17-36, 33-17-41 OMAP Prior Authorization of Brineura (cerliponase alfa) - Pharmacy Services 12/27/2017 01/08/2018
01-17-42, 02-17-37, 03-17-37, 08-17-44, 09-17-41, 11-17-37, 14-17-38, 24-17-38, 27-17-39, 30-17-38, 31-17-43, 32-17-37, 33-17-42 OMAP Prior Authorization of Bone Resorption Suppression and Related Agents - Pharmacy Services 12/27/2017 01/08/2018
01-17-35, 02-17-30, 03-17-30, 08-17-37, 09-17-34, 11-17-30, 14-17-31, 24-17-31, 27-17-32, 30-17-31, 31-17-36, 32-17-30, 33-17-35 OMAP Prior Authorization of Antibiotics, GI and Related Agents - Pharmacy Services 12/14/2017 01/08/2018
00-17-03 ODP Individual Support Plans for Individuals Receiving Targeted Support Management, Base Funded Services, Consolidated or P/FDS Waiver Services, or Who Reside in an ICF/ID 12/01/2017 12/01/2017
35-17-02 OMAP School-Based ACCESS Program Provider Handbook 11/22/2017 11/22/2017
OA-2017-03 OA Maximum Rate of State Participation for Employee Benefits for County Children and Youth Agencies and Mental Health/Intellectual Disabilities/Early Intervention Programs 08/30/2017 08/30/2017
OMHSAS-17-04 OMHSAS Physician/Certified Registered Nurse Practitioner Collaboration Procedures 08/29/2017 08/29/2017
OMHSAS-17-03 OMHSAS Special Pharmaceutical Benefits Program-Mental Health 08/29/2017 08/29/2017

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