ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
QP83-21 MHCP Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Kerendia®
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 27, 2021
တၢ်ဃုသ့ၣ်ညါတၢ်အစၢ
တၢ်ပာ်ဖျါ 2051 - 2060 လၢ 3685 အစၢတဖၣ်အကျါ
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
QP84-21 MHCP Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) Criteria: Cholestasis Pruritis
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 27, 2021
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Hyperpolarization-Activated Cyclic Nucleotide-Gated (HCN) Channel Blocker (Corlanor) - Commercial
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 01, 2024
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Hemophilia Factor IX - Commercial
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲ အမုၢ်နံၤမုၢ်သီ- လါစဲးပတ့ဘၢၣ် 01, 2024
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
2021 November Bulletins
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါနိၣ်၀့ဘၢၣ် 01, 2021
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Bariatric Surgery Commercial Pre-Authorization Request Form (Medical Policy IV-19) (PDF)
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
QP85R1-21 Resolution Process for Providers Serving Minnesota Health Care Programs (MHCP) Members
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲ အမုၢ်နံၤမုၢ်သီ- လါမ့ၤ 11, 2022
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Proton Pump Inhibitors (PPI's) - Medicaid
Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 01, 2024
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Proprotein Convertase Subtilisin/kexin type 9 (PCSK9) Inhibitors - Medicaid - Effective Date 02/01/2025
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါဖ့ၤဘြူၤအါရံၤ 01, 2025
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Proprotein Convertase Subtilisin/kexin type 9 (PCSK9) Inhibitors - Commercial - Effective Date 02/01/2025
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါဖ့ၤဘြူၤအါရံၤ 01, 2025