The Department of Healthcare and Family Services (HFS) wishes to inform providers that due to the widespread availability of generic Tamiflu (oseltamivir), the Department will end the temporary procedures outlined in the December 9, 2022 provider notice effective March 1. This affects the Medicaid fee-for-service (FFS) program and the managed care organizations (MCOs).
Effective March 1, the Department will no longer reimburse providers for dispensing brand name Tamiflu or for compounding suspensions with brand name Tamiflu. While there is no current shortage of oral suspension, compounding with the generic oseltamivir will be allowed only in emergency situations, as there still may be localized areas of shortage where demand is high.
The drugs will be removed as preferred products on the Preferred Drug List, and prior authorization will again be required for brand Tamiflu under the FFS program and the MCOs.
Please direct questions regarding this notice to a pharmacy consultant in the Bureau of Professional and Ancillary Services at 877-782-5565 for FFS claims, or the appropriate MCO.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.