Quarterly Formulary Updates Available Online

Highmark regularly updates our prescription drug formularies and related pharmaceutical management procedures. To keep our network physicians apprised of these changes, we provide quarterly formulary updates in the form of Special eBulletins that can be found on the home page of Highmark’s Provider Resource Center.

Providers who do not have internet access or do not use 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 refer to the Pharmacy Program/Formularies pages, accessible from the main menu on the Provider Resource Center (PRC).

This page includes information on:

  • Providing information for exception requests
  • The process for generic substitutions
  • 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. Providers who don’t have internet access may obtain formulary information via phone by using the below 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, click here.

 

esubscribe