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Preferred Drug List (PDL) Updates

Youth Care Health Choice Illinois logo

PO Box 733

Elk Grove Village, IL 60009-0733

April 9, 2021

Dear YouthCare Provider,

This is an important message from YouthCare HealthChoice Illinois.

YouthCare would like to inform you that the coverage of Metformin Hydrochloride ER Modified Release (GLUMETZA) and Metformin Hydrochloride ER Osmotic (FORTAMET) is changing on May 15, 2021 for all members. Effective May 15, 2021, this medication will be removed from the formulary. Please reference the table below for information regarding medication changes and alternative preferred agents.

YouthCare would like to work with you to help transition the impacted members onto a preferred formulary alternative. If a member requires continued therapy for a medication that has been changed, please submit a prior authorization with appropriate clinical documentation. Prior authorizations can be submitted by faxing 844-989-0154.

Impacted Medication

Medication Change

Preferred agents

Metformin Hydrochloride ER Modified Release (GLUMETZA ®)

Non-preferred after 5/15/21

  • Metformin hcl er 500 mg tablet
  • Metformin hcl er 750 mg tablet
  • Metformin hcl 1,000 mg tablet
  • Metformin hcl 500 mg tablet
  • Metformin hcl 850 mg tablet

Metformin Hydrochloride ER Osmotic (FORTAMET ®)

Non-preferred after 5/15/21

  • Metformin hcl er 500 mg tablet
  • Metformin hcl er 750 mg tablet
  • Metformin hcl 1,000 mg tablet
  • Metformin hcl 500 mg tablet
  • Metformin hcl 850 mg tablet

Note:  Active prior authorizations for this medication will not be affected.

If you have any questions, please call YouthCare Provider Services at 844-289-2264.

Sincerely,

YouthCare

May 15, 2021

Dear Provider,

This is an important message from YouthCare HealthChoice Illinois.

YouthCare would like to inform you that the coverage of long acting antipsychotic injectables (Abilify Maintena ®, Aristada ®, Aristada Initio ®, Invega Sustenna ®, and Invega Trinza ®) is changing on June 15, 2021 for all members. Effective June 15, 2021, these medications will be preffered with a prior authorization.  Please reference the table below for information regarding medication changes and alternative preferred agents.

YouthCare would like to work with you to help transition the impacted members onto a preferred formulary alternative. If a member requires continued therapy for a medication that has been changed, please submit a prior authorization with appropriate clinical documentation. Prior authorizations can be submitted by faxing 844-989-0154.

Impacted Medication

Medication Change

Abilify Maintena ®

Preferred with prior authorization after 6/15/2021

Aristada ®

Preferred with prior authorization after 6/15/2021

Aristada Initio ®

Preferred with prior authorization after 6/15/2021

Invega Sustenna ®

Preferred with prior authorization after 6/15/2021

Invega Trinza ®

Preferred with prior authorization after 6/15/2021

Note:  Active prior authorizations for this medication will not be affected.

If you have any questions, please call YouthCare Provider Services at 844-289-2264.

Sincerely,

YouthCare

June 28,2021

 

Dear Providers,

This is an important message from YouthCare

YouthCare would like to inform you after August 1, 2021 melatonin will not be covered.  This includes instances in which DCFS consent has been received.  The change is being enacted due to the Center for Medicare and Medicaid’s (CMS) classification of melatonin and state of Illinois Department of Health and Family Services’ (HFS) rules.

For questions or additional information about this change please contact YouthCare Provider Services at 844-289-2264.

Sincerely,

YouthCare