Forms and Documents
MHCP_Provider_Manual
IHS Pharmacy Prescription Drug Prior Authorization Request Form
Synagis Prior Authorization Request Form
Value-Based Supplemental Rebate Agreement Template
Prescription Drug Prior Authorization Request Form 12.16.24
Prescription Drug Reconsideration Request Form
Medical Drug Prior Authorization Form
October MHCP Pharmacy Module Modernization Project Stakeholder Meeting
Payer Specifications
30 Day Pharmacy Provider Notice
60 Day Pharmacy Provider Notice
Important Pharmacy Notice of Go Live Postponement
90 Day Pharmacy Provider Notice
August MHCP Pharmacy Module Modernization Project Stakeholder Meeting
June MHCP Pharmacy Module Modernization Project Stakeholder Meeting
March MHCP Pharmacy Module Modernization Project Stakeholder Meeting
November MHCP Pharmacy Module Modernization Project Stakeholder Meeting