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Upcoming Pertinent Changes to Member Web Portal

Magellan is implementing pertinent changes to our web portals and web-based applications and tools. Members who desire to check their eligibility, third-party liability, and pharmacy claims, will be able to register on the updated web portal for secure access to this information. Check back here for additional details regarding the date of implementation and registration process of the new and improved web portal.

Upcoming Pertinent Changes to Provider Web Portal

Magellan is implementing pertinent changes to our web portals and web-based applications and tools. The first change will consist of a new look and feel for the web pages and tools, such as Find a Pharmacy and Drug Lookup. While the look may be changing, the functionality of these tools will remain the same.

The second change implements Okta with multifactor authentication for our provider web-based applications accessed via the web portal. Current users of Web Claims Submission (WCS) and/or WebRA will need to complete a short migration process to verify their access credentials and move all existing application permissions to the new Okta platform. A migration step-by-step job aid will be posted to the web portal prior to implementation. If a new pharmacy provider or prescriber would like to register for the secure web-based applications, they can still do so by clicking the Register link to access our User Administration Console (UAC).

Emergency Drug Coverage Reminder

This is a reminder to pharmacies regarding the federal statute that required Medicaid programs to provide payment for dispensing of at least a 72-hour supply for any drugs requiring prior authorizations if prior authorization cannot be obtained outside of Medicaid business hours. View the provider notice for more information.

Preferred Drug List

New Hampshire Fee-for-Service Medicaid recently updated the preferred drug list. It is effective 09/01/2022. View the PDL.

Diabetic Supply Program

New Hampshire Fee-for-Service Medicaid recently updated the preferred diabetic supply list. It is effective 10/01/2022. View the preferred diabetic supply list.

Pharmacy Program Changes

Effective 04/14/2022, pharmacy claims for At-Home Over-The-Counter COVID-19 Test Kits are covered under Medicare benefit for dual eligible members. For details see the provider notice.

Effective 01/21/2022, pharmacy claims for At-Home Over-The-Counter COVID-19 Test Kits will be reimbursed at Point of Sale. For details see the provider notice.

PERM - Payment Error Rate Measurement

The PERM Audit is designed to measure improper payments in the Medicaid and CHIP programs, as required by the Improper Payments Information Act (IPIA) of 2002 (amended in 2010 by the Improper Payments Elimination and Recovery Improvement Act or IPERA, and the Improper Payments Elimination and Recovery Improvement Act of 2012 IPERIA). The improper payment rates are based on reviews of the Fee-for-Service (FFS), managed care, and eligibility components of Medicaid and CHIP in the year under review.

Beginning in April 2022, the Center for Medicare and Medicaid Services (CMS) will be starting the New Hampshire PERM review of NH Medicaid claims and provider enrollment.

Providers will be receiving medical document request from the CMS PERM contractor, NCI Information System, Inc. starting in April 2022. Providers must submit the requested information by the due date noted on the request. Please note that it will be the responsibility of the billing provider identified on the claim to ensure that all supporting medical records, from the provider who rendered a Medicaid covered service for which the claim payment under review was requested, is submitted in a timely manner.

Morphine Equivalent Dose Calculator

The Morphine Equivalent Dose Calculator calculates the dosage of common opioids as equivalent to 1mg of Morphine.

The calculator is courtesy of the Washington State Agency Medical Directors' Group.