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Unless otherwise specified, all requests to “grandfather” existing drug therapy will require clinical reasoning from the prescriber detailing why the patient cannot be transitioned to a preferred agent from the medicaid pdl. Prescription drug lists prescription drugs can help you manage acute and chronic conditions The following changes will be made to the preferred drug list (pdl), effective january 1, 2025, pending approval by the secretary of the department of human services.
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Effective july 1, 2025, the following changes will be made to the pdl pending recommendation and/or approval by the p&t committee, the bureau for medical services (bms), and the west virginia department of human services (dohs) secretary. Monday to friday (except holidays) from april 1 through september 30. Caresource ® uses a drug formulary (2025 | 2026) that is updated regularly
Summary of formulary changes effective january 1, 2025
Your formulary is an important part of your prescription drug benefit because it shows what drugs may be covered for you, what limits may apply, and what tier drugs are in. West virginia medicaid pdl recommended changes summary pharmacy and therapeutics committee meeting january 22, 2025
