[Provider] Plavix for outpatient use

[Provider Notification]

ATTENTION:   Providers who prescribe Plavix for outpatient use 

 

Plavix will NOT require Prior Authorization (PA) when it is prescribed
for patients who 

 

*        have a percutaneous angioplasty procedure (PCI) scheduled, or 

*        have had percuntaneous angioplasty (PCI)  procedure in the past
12 months.  

 

When you are prescribing Plavix for such a patient, please write on the
prescription: "PCI procedure" scheduled for (date)" or ""PCI procedure
occurred (date)".  (Note: documentation may be requested for audit
purposes.)

 

This exception applies only for these patients and only for brand name
Plavix.  For all other patients prescribed Plavix and for all patients
prescribed Clopidogrel (the generic of Plavix), the normal Prior
Authorization criteria and process will apply.  

 

If you have any questions about Plavix or prior authorization
requirements please contact GHS Prior Authorization at 888-445-0497 or
Pharmacy Help Desk at 888-420-9711.

 

This is a one-way communication.  Please do not respond to this message.

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