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23-279sum Medication Trend Updates and Formulary Changes- 2nd Quarter 2023

Date: 04/04/23

Know what’s changed or changing and plan accordingly

Several FDA-approved biosimilars of Humira will become available in 2023 to treat a number of autoimmune conditions in adult and children including rheumatoid arthritis, Crohn’s disease and ulcerative colitis.

All buprenorphine prescriptions now only require a standard DEA registration number. The previously used DATA-Waiver (also known as X-Waiver) registration numbers are no longer needed for any prescription.

These medication safety issues and a list of recent changes to the Health Net* commercial Formulary, Medi-Cal drug benefits and Medicare Part D Formulary are available in the complete provider update 23-279, Medication Trend Updates and Formulary Changes – 2nd Quarter 2023 (PDF). The list contains brand-name prescription medications, statuses, alternatives, and comments.

You can access this update in the Provider Library. Select your line of business. Then go to Updates and Letters > Updates and Letters for 2020 and Beyond.

Complete lists of the commercial Formularies, Medi-Cal drug benefits and Medicare Part D Formularies are available on the Health Net provider website. Once on the website, the lists are viewable under Pharmacy Information.

Pharmacy help line

For more information regarding changes to the Health Net Commercial Formulary, Medi-Cal drug benefits, or Medicare Part D Formulary, contact the proper pharmacy phone numbers listed below.

Product

Phone number

Fax Number

Pharmacy Benefit (Medi-Cal Rx)

800-977-2273

800-869-4325

Medical Benefit Drugs (Medi-Cal)

800-675-6110

833-953-3436

Commercial Pharmacy Services

800-548-5524, option #3

866-399-0929

Medicare Pharmacy Service Center

800-867-6564

800-977-8226

Additional information

If you have questions regarding the information contained in this update, contact the Health Net Provider Services Center by email at, by phone or through the Health Net provider website.

Line of business

Phone number

Email address

IFP Ambetter PPO

844-463-8188

provider_services@healthnet.com

IFP Ambetter HMO

888-926-2164

provider_services@healthnet.com

Health Net Employer Group HMO, POS, HSP, PPO, & EPO

800-641-7761

provider_services@healthnet.com

Medicare (Individual & Employer Group)

800-929-9224

provider_services@healthnet.com

Medi-Cal

800-675-6110

N/A

 

This information applies to Physicians and Participating Physician Groups (PPGs).

For Medi-Cal, This information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.



Last Updated: 06/24/2024