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Effective April 1, 2024: Pharmacy and Biopharmacy Policies

Date: 03/21/24

Superior HealthPlan has added and updated certain pharmacy and biopharmacy policies to ensure medical necessity review criteria is current and appropriate for members and the scope of services provided. As a result, the following policies are effective on April 1, 2024, at 12:00AM.

Changes in these policies reflect preauthorization requirement amendments that are less burdensome to insureds, physicians, or health care providers.

POLICY

APPLICABLE PRODUCTS

NEW POLICY OVERVIEW OR UPDATED POLICY REVISIONS

Dasatinib (Sprycel, Phyrago) (CP.PHAR.72)

Ambetter

Policy updates include:

  • Added brand Phyrago for adult use to all indications
  • Updated Appendix D to include Oklahoma.

 

To review all policies, please visit Superior’s Clinical, Payment & Pharmacy Policies webpage.

Prior to updates, pharmacy and biopharmacy clinical policies are reviewed and approved by the Pharmacy and Therapeutics (P&T) Committee.

For questions or additional information, please contact Superior’s Pharmacy Department at 1-800-218-7453, ext. 22272.