Quarterly Formulary Updates Available Online

Highmark regularly updates its prescription drug formularies and related pharmaceutical management procedures. To keep our network physicians apprised of these changes, quarterly formulary updates are provided in the form of Special eBulletins.

These Special eBulletins are available online . Additionally, notices are placed on the Provider Resource Center’s (PRC) in the Hot Topics section to alert physicians when new quarterly formulary update Special eBulletins are available.

Providers who do not have internet access or have not enrolled in NaviNet®, may request paper copies of the formulary updates by calling our Pharmacy area toll-free at 1-800-600-2227.

Pharmaceutical Management Procedures

To learn more about how to use pharmaceutical management procedures, please refer to the Pharmacy Program/Formularies page, which is accessible from the main menu on the Provider Resource Center (PRC). This includes information regarding exception requests; the process for generic substitutions; and explanations of limits/quotas, therapeutic interchange, and step-therapy protocols.

Federal Employee Program (FEP) Drug Formularies and Pharmaceutical Management Procedures

The FEP specific drug formularies are available online using the following links:

Providers who do not have internet access may obtain FEP Pharmacy information via phone by using the following toll free numbers and following the prompts for Pharmacy:

  • Delaware: 1-800-721-8005
  • Pennsylvania: 1-866-763-3608
  • West Virginia: 1-800-535-5266

To learn more about the FEP exception request processes for Non-formulary drugs, use the following link: www.fepblue.org/claim-forms .

 

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