Gainwell Technologies, the Single PBM for Medicaid, announced that effective April 1, per Ohio Administrative Code Rule 5160-1-01, products will only be covered if they are determined to be medically necessary. Concurrent pharmacy claims for Glucagon-Like Peptide-1 Agonists (GLP-1s) and Dipeptidyl Peptidase-4 Inhibitors (DPP-4s) will deny at point-of-sale. Affected members and prescribers have been notified of the change.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.