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Effective April 1, 2021: Pharmacy and Biopharmacy Policies

Date: 01/26/21

Superior HealthPlan has created a new policy and revised existing pharmacy and biopharmacy policies to ensure medical necessity review criteria is current and appropriate for members and the scope of services provided. As a result the following policies have been created, revised or retired:

Policy

Applicable Products

New Policy Overview or Updated Policy Revisions

Stiripentol (Diacomit) (CP.PMN.184)

Ambetter

Policy updates include:

  • Added redirection to Epidiolex

 

Fenfluramine (Fintepla) (CP.PMN.246)

Ambetter

Policy updates include:

  • Added redirection to Epidiolex

To review all Clinical policies, please visit Superior’s Clinical, Payment & Pharmacy Policies webpage.

Prior to updates, pharmacy and biopharmacy clinical policies are reviewed and approved by the Pharmacy and Therapeutics (P&T) Committee.

For questions or additional information, please contact Superior’s Pharmacy Department at 1-800-218-7453, ext. 22272.