Single State Programs

single state programs | magellan rxMagellan Medicaid Administration, Inc. (MMA), part of the Magellan Rx Management division of Magellan Health, Inc., has been selected to manage the preferred drug list (PDL) and supplemental rebate processes for these states.


Manufacturer Contact Form

Arizona

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

Manufacturer Letter

  • Letter (for January 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.

Health First Colorado

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

Request for Offers

  • E-mail sent on November 18, 2022

PDL Drug Class Review Announcement

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.

Florida

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

Participation in the Supplemental Rebate Process for Florida Medicaid

Request for Bid

  • E-mail sent on September 12, 2022
  • Mass review E-mail sent on September 12, 2022

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

View the current:

Georgia

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 meeting.

Useful Links

Request for Offers

  • E-mail sent on August 3, 2022

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.

Texas

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

Texas Medicaid Conditions of Participation

Request for Offers

  • E-mail sent on November 7, 2022

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.