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**** Tip of the Day ****

Click here to learn how to submit pharmacy prior authorizations online to expedite the process:
How to submit online prior authorizations
How to check the status of an online prior authorization

Click here for list of Prior Authorization Forms
Click here for list of State Non-Participating Drug Manufacturers
Click here for the DPAP Application form
*** Drug Rebate Documents ***


Click here for information on web invoicing: Delaware Web Invoicing Information

*** Please complete both documents for each labeler code when applying for Electronic Invoicing ***

Click here for the application for electronic invoicing

Click here for the current Memorandum of understanding for electronic invoicing
(also to be used for claim level detail files from 4Q2011 on)

Click here for the previous Memorandum of understanding for electronic invoicing
(ONLY to be used for claim level detail files from 3Q2011 and prior)

For questions on web invoicing, email: MoveItDocumentTransfer@hp.com

*** Current W9 ***

Click here for current W-9 for Drug Rebate

*** Contact Us ***

For any questions related to Drug Rebate, email: DEDrugRebate@hp.com
Attention All Providers
Due to an unforeseen scheduling conflict, the P&T meeting scheduled for May 3rd, 2012 has been pushed back one week to May 10th, 2012. The meeting will still occur at the Delaware Technical & Community College Stanton Campus from 12:30pm-6pm.

Please contact Pharmacy Services at 1.800.999.3371 select option 0, select option 1 for further clarification.

Attention Pharmacy and Medical Providers
The PDL document has been updated with changes in the cough & cold formulations. The implementation of this category will occur on February 3rd, 2012.

The updated PDL is on the provider web page at www.dmap.state.de.us under The Pharmacy Corner.

Please contact Pharmacy Services at 1.800.999.3371 select option 0, select option 1 for further clarification.

Attention Pharmacy Providers
The final Delaware Maximum Allowable Cost (DMAC) list has been placed on the provider web page under DMAC List (final) on the Pharmacy Corner. The new DMAC list prices will be effective on January 13th, 2012. Please refer to your billing manual for the inquiry worksheet to submit any comments.

Please contact Pharmacy Services at 1.800.999.3371 (option 0, option 1) for further clarification.

DUR Board Information
The date for the next meeting is scheduled for Monday, February 13, 2012. The time remains at 7:00 - 9:00 pm. The minutes from the September meeting have been posted.

Pharmaceutical and Therapeutics (P&T) Committee
The Pharmaceutical and Therapeutics (P&T) Committee has been established by DMMA to provide clinical leadership in the selection of preferred medications. This selection will be based on a review of the relative clinical effectiveness and cost of products within selected therapeutic classes. The program's objective is to achieve quality pharmaceutical care for recipients enrolled in the Department.s Medicaid programs while providing significant state savings.

- P & T Committee Meeting -

The Delaware P&T meeting is scheduled for Thursday, May 10, 2012.
12:30 p.m. - 6:00 p.m.

 Delaware Technical & Community College, Stanton Campus
 Directions to Stanton Campus

*Times listed are approximations. The public portion of the meeting will start NO EARLIER then the time listed and may be subject to delays.

Categories for Review
Categories for Review are available under the P&T Agenda link on this page

Pharmacy Provider Manual
DMAC List (current)
DMAC List (proposed)
What's New
 
Prior Authorization Forms

Pharmacy General Information

Medicare Prescription Drug Coverage

Pharmacy Billing Reference Sheet

P&T

PDL List

P&T Bylaws


P&T Committee Members

P&T Meeting Minutes

P&T Meeting Agenda

P&T Schedule

Public Testimony Guidelines

Mental Health Drug Coverage

Email Address: PandTPublicTestimony

DUR

DUR Bylaws

DUR Board Members

DUR Board Meeting Minutes

DUR Meeting Agenda

DUR Board Schedule

Email Address: DURBoardPublicTestimony
 

Back to DMAP Home Page


Pharmacy Corner


The DMAP policy for pharmacies can be found in the Pharmacy Provider Specific Policy Manual. Appendix F of the manual contains all forms required for prior authorization of medications. The manual can be accessed on the left sidebar.

The Medicaid Management Information System (MMIS) supports Retro-DUR and Pro-DUR functionality. Clinical data is used by the Delaware Drug Utilization Review (DUR) Board to evaluate trends in prescribing and utilization as well as cost savings from decreased hospitalizations and avoided expenses for inappropriate therapeutic sessions. Follow the DUR Board link on the sidebar at the left for notes from the Delaware DUR Board meetings.

Effective October 14, 2009, DMAP pays AWP minus 14.5% for branded drugs for traditional pharmacies and AWP minus 18% for non-traditional pharmacies except where the usual and customary is less or there is a FUL, MAC or DMAC. The DMAC list can be accessed on the left sidebar. NOTE: Several times a year, EDS will provide a "draft" DMAC to preview upcoming DMAC pricing. Use caution when selecting the current DMAC.

The What's New page provides a description of the most recent changes in DMAP policy and procedures. Notification of provider alerts, Special Bulletins and provider manual changes are available through this link.


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