Provider : Pharmacy Services

The management of outpatient prescription drugs is an integral part of the medical management program to improve the health and well-being of our members. Prescriber and member involvement is critical to the success of the pharmacy program.

To help your patients get the most out of their pharmacy benefit please be cognizant of the following guidelines when prescribing:

Preferred Drug List (Medicaid)
Preferred Drug List (Dual-Eligible Members)

HI Medicaid Cough Cold Drug List
Abbreviated Preferred Drug List

Pharmacy Forms

• Abbott Request Fax Order Form
• Accu-Chek Meter Form
• Coverage Determination Request Form (Medicare)
• Drug Evaluation Review Form (Medicaid)
• Injectable-Infusion Form (Medicaid)
• Injectable-Infusion Form (Medicare)
• Synagis Form

Medical Injectibles Prior Authorization Requirements:

'Ohana continuously strives to reduce barriers to care and therapies. In reviewing our medical injectible prior authorization requirements, 'Ohana identified an opportunity to consolidate and align the list of required codes. We have combined our Medical and Pharmacy injectible prior authorization code lists into one consistent list, and aligned that list with current industry practice.
No Authorization Required Medical Injectible List - Effective December 7, 2010

The 'Ohana Health Plan Pharmacy Department telephone number is 1-888-505-1198 for Medicaid or 1-866-653-0976 for Medicare. For detailed information about pharmacy services, refer to the Pharmacy section of the 'Ohana Provider Manual.