Important NPL updates
The following new-to-market drugs require precertification:
Effective July 1, 2019, the following new-to-market drugs require precertification:
Effective August 1, 2019, precertification is required for both the drug and site of care for Cutaquig® (IVIG).
Effective January 1, 2020, precertification is required for both the drug and the site of care for the following drugs:
Effective January 1, 2020, the following drugs will no longer require precertification:
We encourage you to submit precertification requests at least two weeks before the scheduled services.
To save time, request precertification electronically — it’s fast and simple. Most precertification requests can be submitted electronically through the provider website or by using your Electronic Medical Record (EMR) system portal.
You can find more information about precertification under the General Information section of the NPL.
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Each main plan type has more than one subtype. Some subtypes have five tiers of coverage. Others have four tiers, three tiers or two tiers. This search will use the five-tier subtype. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. Do you want to continue?
