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Prior Authorization (PA) Forms & Related Info
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Pharmacy
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Visitor
July 25, 2008
Provider Help Desk:
(p) 888-420-9711 (f) 800-408-1088
| Member Help Desk:
(p) 866-796-2463 (f) 207-287-8601
Prior Authorization (PA) Helpdesk
(for Provider PA inquiries)
:
(p) 888-445-0497 (f) 888-879-6938
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General Pharmacy Info
(click column headers to sort)
Name
Description
Date
MaineCare MAC List Effective 07.24.2008
272 kB
7/11/2008
MaineCare MAC List Effective 06.26.2008
271 kB
6/17/2008
MaineCare MAC List Effective 05.22.2008
267 kB
5/13/2008
MaineCare MAC List Effective 04.24.2008
265 kB
4/16/2008
MaineCare MAC List Effective 03.27.2008
266 kB
3/20/2008
MaineCare MAC List Effective 3.20.2008
255 kB
3/20/2008
MaineCare MAC List Effective 03.13.2008
238 kB
3/20/2008
MaineCare MAC List Effective 02.28.2008
214 kB
2/20/2008
MaineCare MAC List Effective 01.24.2008
475 kB
2/4/2008
MaineCare MAC List Effective 12.28.2007
518 kB
12/26/2007
MaineCare MAC List Effective 11.22.2007
253 kB
11/15/2007
Pharmacy Listing by NABP Number
108 kB
10/31/2007
MaineCare MAC List Effective 10.25.2007
221 kB
10/26/2007
MaineCare MAC List Effective 09.27.2007
221 kB
9/19/2007
MaineCare Mac List Effective 8.24.2007
192 kB
8/22/2007
MaineCare MAC List Effective 08.02.2007
190 kB
7/23/2007
MaineCare MAC List Effective 06.28.2007
184 kB
6/13/2007
MaineCare MAC List Effective 05.24.2007
181 kB
5/18/2007
MaineCare MAC List Effective 04.26.2007
180 kB
4/20/2007
NPI Memo April 17, 2007
27 kB
4/17/2007
MaineCare MAC List Effective 03.22.2007
175 kB
3/15/2007
MaineCare MAC List Effective 02.23.2007
165 kB
3/5/2007
Instructions for Submitting Claims for Unassigned Duals & MEPARTD Wrap Processing
55 kB
10/25/2006
Enhancement to the MaineCare Safety Net for Unassigned Duals
22 kB
8/16/2006
MEDEL MEPARTD Update
400 kB
8/16/2006
Part D RAC Category chart PROVIDER VERSION
76 kB
8/16/2006
Medicare Part D Manual Claim Form
222 kB
1/31/2006
Emergency Procedure for Part D issues
402 kB
1/3/2006
Medicare Part D PDP Contact Information (USA)
159 kB
12/30/2005
Medicare Part D Q & A
32 kB
12/30/2005
MaineCare: Medicare Part D Excluded Drugs
26 kB
12/15/2005
Zoloft Splitting Table
36 kB
6/24/2005
MaineCare Diabetic Supply List
41 kB
3/28/2007
Celexa/Citalopram Splitting Table - 01.06.2004
34 kB
4/19/2005
DAW 8 List - 01/23/2004
31 kB
4/19/2005
Diabetic Supplies Information - 09/30/2003
53 kB
4/19/2005
Diag. SC Eligible Drug List - Current
56 kB
4/19/2005
Lexapro Splitting Table - 08/27/2004
15 kB
2/19/2007
MaineCare Compound Claim Form
206 kB
4/19/2005
MaineCare Covered Asthma Supplies List - 02/14/2004
61 kB
4/19/2005
MaineCare Diagnosis Codes - 01/09/2004
38 kB
4/19/2005
MaineCare OTC MAC List - Effective 04/28/2005
399 B
3/29/2005
MaineCare PA Conversion Chart
54 kB
4/19/2005
MaineCare Physician's J-Code/NDC Crosswalk Report - 05/12/2004
19 kB
4/19/2005
MaineCare Restricted Direct Supply Drug List - 12/2004
19 kB
4/19/2005
MaineCare Reversal Form
69 kB
1/12/2007
MaineCare Specialty Direct Supply Drug List - 9.27.2005
57 kB
9/27/2005
MaineCare Supplemental Request Form
223 kB
4/19/2005
Pharmaceutical Companies Contact List - 08/13/2004
465 kB
4/19/2005
MaineCare MAC List Effective 08.23.2007
192 kB
3/14/2008
View the General Pharmacy Info Archive
Memos and Mailings
(click column headers to sort)
Name
Description
Date
PDL updates effective 07/03/08
58 kB
7/11/2008
Pharmacy Benefit Update - Spring 2008
1 MB
4/29/2008
PDL Updates Effective 04/17/2008
58 kB
4/14/2008
PDL Changes Effective 01/03/2008
30 kB
12/27/2007
Pharmacy Benefit Update Newsletter Fall 2007
2 MB
12/27/2007
Pharmacy Benefit Update -Summer 2007
2 MB
11/1/2007
Pharmacy MSP Conversion Letter
43 kB
7/9/2007
Pharmacy Co-Pay 6-07
39 kB
7/9/2007
MSP Letter
28 kB
7/9/2007
I Care 5 + Chronic Meds (060507)
28 kB
7/9/2007
HCFA (J-Code) Rejection Process
57 kB
7/9/2007
Provider Letter - 4 Brand Limit Information
30 kB
7/3/2007
Pharmacy Benefit Update - Spring 2007
100 kB
6/22/2007
PDL Changes Effective 06/14/07
25 kB
6/14/2007
Miscellaneous PDL Changes Effective May 24, 2007
25 kB
5/23/2007
Oxycontin Changes and PDL updates effective 05/17/2007
26 kB
5/11/2007
PDL-Changes-Effective-04.05.07.htm
3 kB
5/9/2007
Duragesic and fentanyl provider newsletter
23 kB
5/3/2007
PDL Changes effective 04/19/2007
29 kB
5/9/2007
Pharmacy Benefit Update - Winter 2007
185 kB
3/14/2007
Pharmacy Benefit Update - Fall 2006
102 kB
12/4/2006
Pharmacy Benefit Update - Summer 2006
66 kB
9/19/2006
View the Memos & Mailings Archive
Maine Rx Plus
(click column headers to sort)
Name
Description
Date
MaineRx Plus Pharmacy List
121 kB
3/2/2006
View the Maine Rx Plus Archive
DEL Information
(click column headers to sort)
Name
Description
Date
MEDEL: Medicare Part D Excluded Drugs
28 kB
12/15/2005
MEDEL OTC Drug List
46 kB
8/30/2005
MEDEL Supplemental Drug List
37 kB
8/30/2005
MEDEL Basic Drug List
83 kB
8/30/2005
Medicare Cost Avoidance Drug Listing Alphabetical - 05/12/2004
138 kB
4/19/2005
Medicare Cost Avoidance Drug Listing by NDC - 05/12/2004
136 kB
4/19/2005
Medicare Drug Benefit Comparison - 04/27/2004
35 kB
4/19/2005
Medicare Drug Discount Card Press Release - 04/27/2004
24 kB
4/19/2005
Medicare/DEL Letter to Members - 04/27/2004
357 kB
4/19/2005
MEDEL Catastrophic Cap Qualifying NDC Numbers - 03/28/2005
1 MB
3/29/2005
MEDEL - Catastrophic Benefit Newsletter - 03/28/2005
22 kB
3/29/2005
View the DEL Information Archive
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