Drug Information
| Preferred Drug List (PDL) | DATE ADDED |
|---|---|
Kentucky Medicaid PDL Effective 12/1/2024
|
12/01/2024 |
| Prior Authorization (PA) Criteria | DATE ADDED |
|---|---|
|
Prior Authorization (PA) Criteria - Effective 12/1/2024
|
12/01/2024 |
|
Wegovy PA Criteria - Effective 7/1/2024
|
07/19/2024 |
| Quantity Limits | DATE ADDED |
|---|---|
|
Maximum Quantity Limits - Effective 12/1/2024
|
12/01/2024 |
| Other Drug Information | DATE ADDED |
|---|---|
|
Aduhelm - Prescriber Administered Drug Prior Authorization Criteria
|
04/08/2022 |
|
Diabetic Supplies Preferred Drug List - Effective 7/1/2024
|
07/05/2024 |
|
Kentucky Medicaid Pharmacy Injectable Drug List
|
11/08/2024 |
|
Kentucky Medicaid Vaccine List - FFS & MCO
|
07/26/2024 |
|
Over-the-Counter (OTC) Drug List - FFS Only
|
10/18/2024 |
|
Over-the-Counter (OTC) Drug List - MCO Only
|
10/18/2024 |