On 2/1/23 CHPW implemented the HCA’s new clinical policy for Soma (carisoprodol). This policy applies to CHPW Apple Health members requesting coverage for Soma (carisoprodol). The policy aims to limit carisoprodol use for acute, painful musculoskeletal conditions. Providers with members that have existing authorizations are encouraged to taper their patients off this medication. If a provider has a member that does meet criteria for approval, the medication will be limited to 4 tablets per day for 21 days only.
The full policy can be found here: https://www.hca.wa.gov/assets/billers-and-providers/musculoskeletal_agents_carisoprodol.pdf
If you have any questions, please call CHPW customer service at 1-800-440-1561.