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Medicaid Pharmacy Program

*UPDATED: Change to the Office of Pharmacy Services Fee-for-Service Medicaid Helpline -- April 22, 2020​​ ​

​Medicaid Coronavirus Disease 2019 (COVID-19) Updates​

During this rapid​ly evolving situation, we will provide updates as they become available. All Medicaid Providers should check the Medicaid COVID-19 Provider Updates page often for updates. For general coronavirus information, visit coronavirus.maryland.gov​​​​.
 
 

New! Small Rural Pharmacy Grants Program

Please click here to see information on the new grants program offered by the Maryland Medicaid Pharmacy Program for Maryland's small rural pharmacies.
 

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Notice:  Pharmacy Helpline

Due to the State of emergency as a result of the 2019 Novel Coronavirus Pandemic (COVID-19), effective April 24, 2020, the Maryland Department of Health (MDH) Office of Pharmacy Services Fee-for-Service Medicaid Helpline is transitioning to a voicemail system. Read MDH Office of Pharmacy Services Call Center Helpline Changes to Voicemail System for more information. 

Prior Authorization for Antipsychotic Medications

For our Prior Authorization forms, see the links below.

Request to Authorize Antipsychotic Prescription for Youth 17 and Younger -- Form revised 04/17/18

For Tier 2 and non-preferred prior authorization --  Antipsychotic Prior Authorization Form for Patients 18 Years of Age and Older​  ​ ​​

​​Information for Consumers

The Maryland Medicaid Pharmacy Program (MPP) provides services for the following programs:​

Medical Assistance

Receive complete pharmacy services.

HealthChoice

Mental Health Formulary, Substance Use Disorder Medication Clinical Criteria Final. All other drugs are provided by HealthChoice Managed Care Organizations (MCOs).

Family Planning

Receive only contraceptives and sexually transmitted infections treatment.

Medicare Part D

Fully dual eligible Medicare beneficiaries receive most drugs excluded from Medicare Coverage. All other drugs are provided by Medicare Prescription Drug Programs (PDPs). Please note that beginning 01/01/2013, drug coverage for Benzodiazepines and Barbiturates for those patients that are both Medicaid and Medicare eligible,will be provided by Medicare Part D Prescription Drug Plans and not the Maryland Medicaid Pharmacy Program. This change may cause patient co-payments to vary.​​​

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