| TITLE | Line of Business | Effective Date |
|---|---|---|
| Discharge Policy (PDF) | All lines of business | March 1, 2024 |
| Drug Trial and Failure (PDF) | All lines of business | December 1, 2023 |
| High Daily Morphine Milligram Equivalent (PDF) | Medicare | December 1, 2023 |
| IEHP Drug Prior Authorization Policy (PDF) | All lines of business | December 1, 2023 |
| Intradialytic Parenteral Nutrition (IDPN) Policy (PDF) | All lines of business | March 1, 2024 |
| Non-Formulary Drug (PDF) | All lines of business | December 1, 2023 |
| Non-Sterile Compounded Medication (PDF) | All lines of business | December 1, 2023 |
| Off-Label Indication Policy (PDF) | All lines of business | March 1, 2024 |
| Pharmacy Drug Management Program for Pain (PDF) | All lines of business | December 1, 2023 |
| Quantity Limit Policy (PDF) | All lines of business | December 1, 2023 |
Information on this page is current as of March 1, 2024.
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