2023 Pharmacy Resources
- Medically Administered Medication Payment Policy
- Medicaid HCPCS Codes Required to be Submitted with an NDC
- 2021/2022 State Supplied Influenza Vaccine Update
- Neighborhood Site of Care Policy Appendix
Medicaid and Commercial Limited Specialty Pharmacy Network
Starting January 1, 2023, Neighborhood’s Specialty Pharmacy Network for our Medicaid and Commercial members will be the following three Specialty Pharmacies:
- Care New England Specialty Pharmacy
- CVS Specialty Pharmacy
- Lifespan Specialty Pharmacy
Limited Distribution Drugs not available at Care New England Specialty Pharmacy, CVS Specialty Pharmacy, and/or Lifespan Specialty Pharmacy can continue to be filled at the member’s current Specialty Pharmacy.
*Medication availability at network Specialty Pharmacies does not guarantee drug coverage.
New Century Health – Oncology/Hematology Requests
- New Century Health Portal: https://my.newcenturyhealth.com
- New Century Health Fax: 877-624-8602
- New Century Health Phone: 888-999-7713
Searchable Formularies
- Medicaid Searchable Formulary
- 2021 Commercial Searchable Formulary
- 2022 Commercial Searchable Formulary
- 2023 Commercial Searchable Formulary
- 2022 INTEGRITY (MMP) Searchable Formulary
- 2023 INTEGRITY (MMP) Searchable Formulary
- Medical Pharmacy Benefit Searchable HCPCS Listing
- To view the Check Drug Cost Tool, go to our Member page and select the specific Commercial Plan you need, or view the Searchable PDF below. *co-pays may vary.
*To link your EHR to Neighborhood formularies, have your EHR Vendor contact Surescripts®
Downloadable Formularies
Medicaid Formulary
- EFP Pharmacy Benefit
- EFP Medical Benefit
- Non Formulary Quantity Limits
- 2022 Formulary Foreword – Medicaid
- 2023 Formulary Foreword – Medicaid
- Medicaid Formulary Changes January 2023
- Medicaid Formulary Changes February 2023
- Medicaid and Commercial Medical Benefit Step Therapy
2023 Commercial Formulary
2022 Commercial Formulary
2021 Commercial Formulary
- 2022 Formulary Foreword – Commercial
- 2023 Formulary Foreword – Commercial
- Commercial Notice of Change December 2022
- Commercial Formulary Changes January 2023
- Commercial Formulary Changes February 2023
- Medicaid and Commercial Medical Benefit Step Therapy
2022 INTEGRITY (MMP) Formulary
2023 INTEGRITY (MMP) Formulary
- Medicare Part B Medications Requiring Step Therapy
- INTEGRITY Notice of Change December
- INTEGRITY Notice of Change January 2023
- INTEGRITY Notice of Change February 2023
- 2022 MMP ADD File Covered NDC’s
- 2023 MMP ADD File Covered NDC’s
- List of Durable Medical Equipment Available at a Pharmacy
Prior Authorization Information
For the quickest way to request a Prior Authorization (PA), please use CoverMyMeds and complete the request form. It is free and easy to get started:
1. Register for a free account.
2. Select and complete any PA request.
3. Press “Send to Plan” and receive a determination.
Please note that some PA requests may receive an automated response while others may require additional clinical information from the prescriber. Please check CoverMyMeds to view the status of your PA request and/or provide additional information required to complete the request.
For more information about Neighborhood’s Formulary/Pharmaceutical Management Procedures, or any other Pharmacy documents, contact Neighborhood Member Services at 1-800-459-6019.
Helpful Links
24-hour Pharmacies in Neighborhood’s network