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There has been some confusion surrounding the formulary status of Methadone, when used for opioid replacement therapy.
- Beginning 1/1/2017, Methadone is not listed on the AHCCCS Drug List and requires prior authorization (PA) approval when used for pain. Methadone prescription claims prescribed for pain are dispensed by retail pharmacies.
- Methadone when used for opioid replacement therapy (ORT) continues to be available without PA through an Opioid Treatment Program (OTP)/Medication Assisted Treatment (MAT). These claims are not dispensed by retail pharmacies and are billed on a medical claim.
Additionally, all formulary changes are noted on the January formularies listed on our websites:
As always, don't hesitate to contact your Provider Relations Representative with any
questions or comments. You can find this notice and all other provider notices posted on Mercy Maricopa's
website and Mercy Care Plan's
website.
Thanks for all you do!
QB 2324
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