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Formulary Change

FORMULARY UPDATES

EFFECTIVE MAY 10, 2021

CHA is pleased to be able to remove prior authorization requirements for a number of commonly used medication. This will help to reduce the administrative burden for all and streamline care.

FORMULARY CHANGES:

  • HYDROXYZINE HCL (PA REMOVED)
  • HYDROXYZINE PAMOATE (PA REMOVED)
  • FLUTICASONE NASAL SPRAY (PA REMOVED)
  • BACLOFEN 10MG AND 20MG TABLETS (PA REMOVED)
  • CYCLOBENZAPRIINE 5MG AND 10MG TABLETS (PA REMOVED)
  • METHOCARBAMOL 500MG AND 750MG TABLETS (PA REMOVED)
  • TIZANIDINE 2MG AND 4MG TABLETS (PA REMOVED)
  • GABAPENTIN (QTY RESTRICTION REMOVED)

FORMULARY ADDITIONS:

  • OTC VOLTAREN ARTHRITIS PAIN (NO PA REQUIRED—QL 100 GRAMS PER 30 DAYS)

CHOICE 90 ADDITIONS:

  • FLUORIDE CHEWABLES
  • MULTIVITAMIN WITH FLUORIDE CHEWABLES
  • PRENATAL PLUS VITAMINS
  • OXYBUTYNIN 5MG TABLETS

Another important opportunity to reduce administrative burden and improve patient compliance is to prescribe 90 day quantities for long-tern generic medications. Eligible 90-day medications for CHA patients can be accessed in our Covered Drugs and on pages 52-53 of the current formulary book. ATRIO covers 90 day fills for nearly all medications that are not controlled substances.