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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

July 2017

CVS Health–NovoLogix: Prior Authorization for Overlapping Medical/Pharmacy Drugs


As we communicated in the May and June issues of Network Matters, prior authorizations for select medical drugs for Harvard Pilgrim’s commercial members are now required through  CVS Health–NovoLogix.

To align with the medical policies for the drugs being managed by CVS Health–NovoLogix, the Pharmacy Department has also implemented prior authorization policies for the following medications, which overlap the medical and pharmacy benefit:  

  • Granix
  • Krystexxa
  • Lupron Depot
  • Lupron Depot Ped
  • Makena
  • Neulasta
  • Neulasta Onpro
  • Neupogen
  • Octreotide Acetate
  • Sandostatin
  • Sandostatin LAR Depot
  • Somatuline Depot
  • Zarxio
  • Zoledronic Acid

The prior authorization process for obtaining these drugs through the pharmacy benefit is the same as the existing process for all other pharmacy drugs; providers must complete the appropriate medication request form and fax it to MedImpact Healthcare Systems at 888-807-6643. For more information, please refer to the Pharmacy section of Harvard Pilgrim's provider website.

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PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator