Implementation starts December 5, 2019
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Update – Ensure all contact information is updated in the New York Medical and Drug Formulary Prior Authorization (PA) Portal. Providers and Payers should ensure information in their file(s) is up to date including the contact information and email addresses for Administrator, Work-Load Administrator, and Level 1 and Level 2 Reviewers. http://www.wcb.ny.gov/medicalportaloverview/
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Educate – All providers, adjusters and pharmacies should take the time to educate themselves on the latest version of the drug formulary list, which contains a newly adopted special consideration #4. This will help streamline the understanding of which drugs require PA and which drugs do not require PA. http://www.wcb.ny.gov/drug-formulary-regulation/NYS-drug-formulary.pdf
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Prepare – Providers, payers, adjusters and Level 1 reviewers should prepare themselves to answer questions regarding the PA process. You are certain to get calls from treating physicians and claimants regarding the PA process and medications. http://workcompauto.optum.com/newyorkformulary
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Communicate – Keep open the lines of communication with all stakeholders, prescribers, claimants and your PBM partners.
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Should you have any last minute questions, please feel free to contact our Government Affairs Team at AskGovtAffairs@optum.com.