Harvard Pilgrim Health Care Home
  HPHConnect
 
  Learn more.
  Sign up for HPHConnect.
Medical Management
E-Transactions
HPHConnect
Pharmacy
For Your Patient
News Center
Network Matters
Newsletter Archives
Newsletter Registration
Newsroom
Office Support
Products
Provider Manual
Medicare Advantage
Research & Teaching
Resources & Links
 
Print    Text Size

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

May 2016

Vraylar: New Clinical Requirements for Coverage


Harvard Pilgrim has enacted a step therapy requirement on the Premium formulary for members beginning treatment with Vraylar (cariprazine), an oral atypical antipsychotic used in adults for the treatment of manic or mixed episodes associated with bipolar I disorder or schizophrenia. Vraylar is not covered on the Value formulary.

Effective immediately, Harvard Pilgrim offers coverage for Vraylar on the Premium formulary provided that it is medically necessary and the member has completed and failed a one-month trial of aripiprazole and one other atypical antipsychotic. Harvard Pilgrim will continue to cover Vraylar for patients who are currently using Vraylar or have used it in the past year. For more information, please refer to the Vraylar Clinical Criteria.

A prior authorization is only required if the member does not meet the step therapy requirement or is on the Value formulary. To request prior authorization, please complete the Vraylar Medication Request Form and fax it to MedImpact Healthcare Systems at 888-807-6643.

Email this article to a colleague   


Network Matters Archives

Download printer-friendly version

CLINICIAN CORNER

Coverage of Narcan Nasal Spray and Evzio

Vraylar: New Clinical Requirements for Coverage

Prior Authorization Required for Taltz

New Medical Policy on Treatment of Benign Prostatic Hypertrophy

Identifying and Treating Obsessive-Compulsive Disorder

OFFICE ASSISTANT

Home Care Seasonal Flu Vaccine Fee Schedule Updated for 2016

Reminder: Keep Panel Status Up to Date

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