HIV Medications Carve-in

Providers,

As of January 1, 2020, all HIV medications were carved-in as a pharmacy benefit to be managed by Maryland Physicians Care (MPC). Members on therapy prior to 1/1/2020 will be allowed to maintain their current regimen for 180 days during this transitional period. MPC would like to inform you that the current prior authorization approvals for non-preferred HIV medications will term on June 30, 2020. Also, members who are new to therapy or members that have changes to their regimen during the transitional period may be impacted by prior authorization. For your convenience, MPC has added several HIV medications in different therapeutic classes to its formulary that do not require prior authorization and allow for 90 days’ supply. On July 1, 2020, there will be no changes to the current formulary so we recommended that you prescribe a formulary preferred medication well in advance of the current authorization expiration to minimize therapeutic disruption.

Please see the Quick Reference HIV Drug Chart to assist with converting regimens to preferred medications. Or visit the MPC Prior Authorization page for information about how to process a new prior authorization request if applicable. If you have any questions you may contact our Provider Services Department at 1-800-953-8854.

Sincerely,

MPC Pharmacy Department