The following formulary changes will be effective starting 7/1/22 for all CHPW Medicaid members. Please visit https://www.hca.wa.gov/billers-providers-partners/programs-and-services/apple-health-preferred-drug-list-pdl for more details.
Moving to not covered status:
ANTIFUNGALS : TOPICAL
- Mycozyl AC cream
Moving to nonpreferred status:
ANTIBIOTICS : VAGINAL
- Vandazole Gel 0.75%
ANTIDIABETICS : INSULIN – PRE-MIXED
- Novolog Mix 70-30 vial
Moving to preferred status:
ANTIHYPERTENSIVES : ACE INHIBITORS
- Quinapril tablets (5, 10, 20, 40 mg)
GASTROINTESTINAL AGENTS – ULCER DRUGS : PROTON PUMP INHIBITORS (PPI)
- Protonix 40 mg suspension packets
GASTROINTESTINAL AGENTS : IRRITABLE BOWEL SYNDROME (IBS) AGENTS / GI MOTILITY
- Movantik tablets (12.5 and 25 mg)
