News

Effective November 1, 2023: Pharmacy and Biopharmacy Policies

Date: 08/22/23

Superior HealthPlan has added, updated or retired certain 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 are effective on November 1, 2023 at 12:00AM.

POLICY	APPLICABLE PRODUCTS	NEW POLICY OVERVIEW OR UPDATED POLICY REVISIONS
Doxycycline (Doryx, Oracea, Acticlate) (CP.PMN.79)	Ambetter and Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP	Policy updates include: For rosacea, added requirement that member must use delayed release doxycycline (generic Oracea)

POLICY

APPLICABLE PRODUCTS

NEW POLICY OVERVIEW OR UPDATED POLICY REVISIONS

Doxycycline (Doryx, Oracea, Acticlate) (CP.PMN.79)

Ambetter and Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP

Policy updates include:

For rosacea, added requirement that member must use delayed release doxycycline (generic Oracea)

To review all 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.