Single State Programs
Magellan Medicaid Administration, Inc. (MMA), part of the Magellan Rx Management division of Prime Therapeutics LLC, has been selected to manage the preferred drug list (PDL) and supplemental rebate processes for these states.
Arizona Health Care Cost Containment System (AHCCCS) is Arizona’s Medicaid agency that offers health care programs to serve Arizona residents. Individuals must meet certain income and other requirements to obtain services.
Useful Links
- Representatives of pharmaceutical companies, Pharmacy Benefit Managers or a related entity must submit testimony in accordance with the AHCCCS Pharmacy & Therapeutics Committee Operational Policy All testimony by representatives of pharmaceutical companies, Pharmacy Benefit Managers and related entities must submit a Public Testimony Registration Form.
Manufacturer Letter
- Letter (for May 2023 meeting)
Offer Form
The Offer Form provides the mechanism for you to submit your proposals for the Supplemental Rebate program.
Line Extension Form
The Arizona Line Extension Form provides the mechanism for your company to submit line extensions for the Supplemental Rebate program.
P&T Meeting Public Testimony Request Form
P&T Meeting Public Testimony, for persons who are not representing a pharmaceutical company, pharmacy benefit manager or related entity, may be given orally or submitted as a written document in accordance with the AHCCCS Pharmacy & Therapeutics Committee Operational Policy
Each person must fill out the Public Testimony Registration Form to register and must also fill out the Conflict of Interest Form. All registrations and testimony must be received 14 business days in advance of the AHCCCS P&T Meeting.
Effective June 27, 2016, the Colorado Medicaid program is now called Health First Colorado. The new name reflects the significant changes that have been made to modernize Colorado’s Medicaid program to engage members and improve the quality and coordination of care. While the name and look of Colorado Medicaid have changed, member eligibility, benefits, and providers will remain the same.
Useful Links
- Classes and Products (April 2023)
Request for Offers
- E-mail sent on February 10, 2023
PDL Drug Class Review Announcement
- Announcement (for April 2023)
Offer Form
The Offer Form provides the mechanism for you to submit your proposals for the Supplemental Rebate program.
Line Extension Form
The Colorado Line Extension Form provides the mechanism for your company to submit line extensions for the Supplemental Rebate program.
The Florida Medicaid program covers 2.2 million beneficiaries and has an annual pharmaceutical budget of over $2.2 billion. Florida’s program, with savings approaching $500 million to date, is considered a national model.
Useful Links
- Preferred Drug List for Florida Medicaid
- Prior Authorization schedule
- P&T schedule
- Upcoming products and classes (June 2023)
- Mass Review List (June 2023)
Participation in the Supplemental Rebate Process for Florida Medicaid
Request for Bid
Offer Form
The Offer Form provides the mechanism for you to submit your proposals for the Supplemental Rebate program.
Line Extension Form
The Florida Line Extension Form provides the mechanism for your company to submit line extensions for the Supplemental Rebate program.
Initial Presentation on the Supplemental Rebate Program
- Program Information (MS PowerPoint)
View the current:
The Georgia Department of Community Health (DCH) has authorized Magellan Medicaid Administration to solicit and contract for supplemental rebates for the Georgia Medicaid Fee-for-Service program effective May 1st, 2018 and forward for all Drug Utilization Review (DUR) Board meetings and class reviews.
Useful Links
- Classes and Products (May 2023)
Request for Offers
- E-mail sent on January 26, 2023
Offer Forms
The Offer Form GNUP provides the mechanism for you to submit your proposals for the Supplemental Rebate program.
Line Extension Form
The Georgia Line Extension Form provides the mechanism for your company to submit line extensions for the Supplemental Rebate program.
Information regarding the Texas Medicaid Drug Addition Process and eCOI, can be found here.
Information regarding the Texas Drug Utilization Review (DUR) Board, along with the current Texas Medicaid PDL, can be found here.
Information regarding the Texas Drug Utilization Review (DUR) Board, along with the current Texas Medicaid PDL, can be found here.
Upcoming Product Review Information
- Classes and Products (April 2023)
Texas Medicaid Conditions of Participation
Request for Offers
- E-mail sent on February 7, 2023
Participation in the Supplemental Rebate Process for Texas Medicaid
The Offer Form provides the mechanism for you to submit your proposals for the Supplemental Rebate program.
Once your company has provided contact information to Provider Synergies, your company’s designated representatives will be notified when one or more of your products are under consideration for the PDL.
Line Extension Form
The Texas Line Extension Form provides the mechanism for your company to submit line extensions for the Supplemental Rebate program.
Provider Synergies, LLC is a subsidiary of Magellan Medicaid Administration, Inc., which is part of Magellan Rx Management, LLC