AHCCCS Pharmacy Information


Continuous Glucose Monitor (CGM) Update

At the October 2021 AHCCCS Pharmacy and Therapeutics Committee meeting, the continuous glucose monitor (CGM) class was reviewed for potential addition by AHCCCS as a supplemental rebate class. After further review, AHCCCS has determined not to add the CGM class for supplemental rebate. AHCCCS is in the process of standardizing medical necessity criteria for the AHCCCS Fee-for-Service program and MCO contractors for publication in the AHCCCS Medical Policy Manual (AMPM). The proposed AMPM CGM medical necessity criteria will be published for public comment through the established AMPM public comment process. Interested parties may subscribe to receive email alerts.

The AHCCCS Pharmacy & Therapeutics Committee (Committee) is advisory to the AHCCCS Administration and is responsible for evaluating scientific evidence of the relative safety, efficacy, effectiveness and clinical appropriateness of prescription drugs. The Committee makes recommendations to the AHCCCS Administration on the development and maintenance of a statewide drug list and prior authorization criteria as appropriate. The Committee may also evaluate individual drugs and therapeutic classes of drugs.

The meetings are open to the public.

P&T Meeting Public Testimony, for persons that are not representing a pharmaceutical company, pharmacy benefit manager or related entity, may be given orally or submitted as a written document in accordance with the AHCCCS P&T Operational Policy

Each person must fill out the Public Testimony Registration Form and the Conflict of Interest Form to register for the meeting. All registrations and testimony must be received at least 14 days in advance of the AHCCCS P&T meeting.

Meeting Schedule

For up to date information regarding supplemental rebates including class reviews and testimony registration, please visit the Provider Synergies Website.

Agendas & Meeting Minutes

ANNOUNCEMENT: All AHCCCS P&T meetings will be held virtually until further notice.

Current P&T Committee Member Information

P&T Application - Now Accepting New Members

The AHCCCS Pharmacy and Therapeutics Committee is now accepting new members for the following positions:

  • Health Care Providers - 3 positions available
    • Family Practice
    • Pain Management
    • Pediatrics
  • Public- 1 position available
    • Medicaid Member
  • AHCCCS MCO's and TRBHA - 2 positions available
    • TRBHA Pharmacy Director
    • TRBHA Medical Director
  • University Representative - 1 position available
    • Researcher

Please update the linked document below for P&T application to the attached committee application document.

Please fill out the P&T Application and send to the Arizona Pharmacy Department ( AHCCCSPharmacyDept@azahcccs.gov ) for consideration.

Supplemental Rebate Vendor

  • Provider Synergies, LLC is an affiliate of Magellan Medicaid Administration contracted with AHCCCS to facilitate and collect rebates for the supplemental rebate program. For up to date information regarding supplemental rebates including class reviews and testimony registration, please visit the Provider Synergies Website.

Communications

For more information, you may contact the Pharmacy Department at AHCCCSPHARMACYDEPT@AZAHCCCS.GOV.

Archived pharmacy documents are available under ‘Pharmacy Updates’ in the AHCCCS Document Archive.