The following changes will be effective 10/01/25 for all CHPW Apple Health (Medicaid) members. Please visit Health Care Authority (HCA) website or CHPW Online Formulary for more details or call CHPW Customer Service at 1-800-440-1561 Monday through Friday from 8am to 5pm.
List of medications moving to PREFERED status
| Medication name | ||
| Clindamycin 1% gel | Clindamycin 1% lotion | Clindamycin 1% pledget |
| Insulin aspart cartridge | Insulin aspart 100 unit/mL flexpen | Insulin aspart 100 unit/mL vial |
| Novolog 100 unit/mL flexpen | Novolog 100 unit/mL vial | Itraconazole capsule |
| Testosterone 50mg (1%) gel in packet (gram) | Voriconazole tablet | |
List of medications moving to NON-PREFERED status
| Medication name | ||
| Aemcolo tablet | Fenofibrate tablet (40mg and 120mg) | Firvanq 25mg/mL |
| Invokamet tablets | Invokana tablets | Mesalamine DR capsules |
| Tretinoin 0.05% gel | Tazarotene 0.1% foam | Sodium sulfacetamide 10% cleanser gel |
| Fesoterodine fumarate ER tablet | Tolterodine tartrate ER capsules | |
List of medications that will NO LONGER require prior authorization
| Medication name | ||
| Bethkis ampule | Kitabis Pak | Tobramycin ampules |
| Solosec granule packets | ||
List of medications moving to PRIOR AUTHORIZTION REQUIRED
| Medication name | ||
| Vowst capsule |
Other HCA and CHPW Clinical Policy, Formulary and Criteria Updates (see table for effective dates)
| Policy | Summary of Update |
| Retired HCA policy
Effective 10/01/25 |
07.00.00-1 Antibiotics – Inhaled Aminoglycosides
|
| New HCA policy
Effective 10/01/25 |
21.40.24 Oncology Agents: Antiandrogens- Oral
|
| Updated HCA policies
Effective 10/01/25 |
30.10.00 Endocrine and Metabolic Agents: Growth Hormones
66.27.00.AB Cytokine and CAM Antagonists: IL-4/IL-13/IL-31 Inhibitors
90.78.40 Topical Immunosuppressives- Calcineurin Inhibitors
|
| Updated HCA policies
Effective 08/01/25 |
66.27.00.AA CAM-TNF Inhibitors
66.27.00.AD CAM-IL12IL23 Inhibitors
Both policies updated for ustekinumab and adalimumab to follow the guidance below. |
| Update to non-preferred biosimilars – ustekinumab and adalimumab
Effective 08/01/25 |
Non-preferred biosimilars of ustekinumab and adalimumab will require trial and failure of the following:
Example: Request for Wezlana (non-preferred ustekinumab biosimilar) for ulcerative colitis must try and fail the following:
|
