Ohio to Transition to Single List of Preferred Medicaid Drugs

January 2020 ~

Ohio has announced that the state will transition to a single list of preferred Medicaid drugs in an attempt to streamline prior authorization and reduce confusion among beneficiaries, providers, and pharmacists.

Under the state’s new Unified Preferred Drug List (UPDL), effective January 2020, insurance companies that manage Ohio Medicaid plans will be required to use its single, transparent list of preferred medications.According to the Ohio Department of Medicaid, the new UPDL will encompass the state’s entire Medicaid population regardless of enrollment in Managed Care or Fee for Service (FFS). The goals of the UPDL include:

• Reducing the administrative burden for providers by streamlining the prior authorization (PA) process across FFS and managed care.
• Consolidating six PDLs into one.
• Facilitating coordination of care for approximately three million covered Medicaid lives.
• Minimizing member movement between the Ohio Medicaid Managed Care Plans.

“Multiple drug lists created headaches, particularly if a member changed plans and the drug name on the list of their new plan differed from the previous plan. The UPDL eliminates the need for the pharmacist to contact their doctor for a new prescription for the same drug under a different name, which could lead to delays in the member getting their prescription filled,” said Ohio Medicaid director, Maureen Corcoran.

“To have that be more streamlined, to be able to count on it, and to not have any of these potential confusion that can occur among drugs is really, really important.” Corcoran continued. “So that families get what they need in a timely way and they’re not left without their medication.”

For more information, refer to the UPDL Frequently Asked Questions page.

Source(s): Ohio Department of Medicaid; Dayton Daily News; Cincinnati Public Radio;