Visit this page frequently for important bulletins, alerts and advisories for Vermont Medicaid enrolled pharmacies.
Communications related to the Change Healthcare Outage are marked with an exclamation point (!)
2025
April
- Important Changes to Coverage for Diabetic Testing Supplies *EFFECTIVE 5/1/25*
January
- J Code Notice of Decision
- Important Notice: Pharmacy Billing for Blood Pressure Monitors
- Important Notice: Changes to Covered Drugs
- Point of Sale (POS) Blackout Period (01.21.2025)
2024
December
- Pharmacy Newsletter
- Administration Fee for Vaccines and Prep Act Extension
- Help Your Patients Quit Tobacco
- Optum RX Holiday hours
November
- Preferred Drug List (PDL) Changes - Effective 1.1.2025
- Coverage Changes COVID-19 Vaccines for Children and Emergency Use Authorized Drugs (11.26.2024)
- Optum Vermont Pharmacy Help Desk Notice: Thanksgiving Holiday Hours (11.25.2024)
- Vermont Medicaid Pharmacy Cost of Dispensing Survey (11.25.2024)
October
September
- COVID-19 Drug Copayment (Effective 10.1.2024)
- Coverage Change for COVID-19 At-Home Over-the-Counter Tests (Effective 10.1.2024)
August
- Influenza (Flu) 2024-2025 Season 8.29.24
- (!) Resources Available to People Who Believe Their Personal Data May Have Been Impacted by the Change Healthcare (CHC) Cyberattack 8.8.24
- Vermont Medicaid- Updated Contact Information
- Notice: Prior Authorization Process for Pharmacies (effective 8.7.24)
- Notice: Prior Authorization Process to Resume for Providers (effective 8.7.24)
July
- (!) Prior Authorization for Physician Administered Drugs (HCPCS Codes) 7.19.24
- (!) Notice: Vermont Medicaid-Prior Authorization 7.17.24
June
- (!) Important Notice: Point of Sale (POS) Patching 6.12.24
- (!) Vermont Medicaid- Drug File Updates 5.31.24
May
- (!) Temporary Dispensing Fee Increase 5.31.24
- (!) Reminder- Preferred Drug List 5.7.24
April
- (!) Important Update: Opioid Safety Checklist for MME 4.12.24
- (!) Gainwell Provider Email Advance Important Information 4.2.24
March
- (!) Department of Vermont Health Access- Claims Processing Information - 3.26.24
- (!) Gainwell Provider Advance Payment Request Instructions 3.25.24 - Gainwell Email Blast
- (!) Update on Change Healthcare Network Outage 3.18.24 - Press Release
- (!) Gainwell Provider Advance Payment Request Instructions 3.18.24 - Gainwell Email Blast
- (!) Update on Change Healthcare Network Outage 3.18.24
- (!) DVHA Encourages Providers to Determine Their Need for Advance Payments 3.15.24
- (!) Pharmacy Copayments - Temporary Elimination 3.15.24
- (!) Gainwell Provider Advance Payment Instructions 3.11.24 - Gainwell Email Blast
- (!) DVHA Provides Update on Change Healthcare Cyber Incident 3.8.24 Press Release
- (!) DVHA Update on Change Healthcare Cyber Security Incident 3.8.24
- (!) Gainwell Provider Advance Payment Instructions 3.4.24 - Gainwell Email Blast
- (!) Vermont Medicaid Voice Response System (VRS) Instructions for Eligibility 3.4.24
- (!) DVHA Thanks Members and Pharmacies for Their Patience During Change Healthcare Cyber Issues 3.1.24 - Press Release
- (!) Regulations and Best Practices for Pharmacists Dispensing Controlled Substances During the Network Service Outage 3.1.24
- (!) Change Healthcare Outage Member Text 3.1.24
February
- (!) Gainwell Prescriber Claims Processing, Eligibility, and Prior Authorization 2.29.24
- (!) Change Healthcare Cyber Security Issue Update 2.28.24 Press Release
- (!) Claim Processing and Medicaid Member Billing 2.28.24
- (!) JCode Submission Process during Change Healthcare System Outage 2.27.24
- (!) Change Healthcare Outage FAQ's 2.26.23
- (!) State Medicaid Pharmacy Claims Contractor Experience Cyber Security Issue and Service 2.23.24 Press Release
- (!) Important Change Healthcare Outage 2.23.24
- (!) Change Healthcare Outage Emergency Text 2.23.24
- (!) Change Healthcare Outage 2.22.24 - FaxBlast_Optum Rx
- Changes to Coverage for COVID-19 A-Home Test - 2.12.24
January
- Levemir Discontinuation 1.26.24
- Flovent Discontinuation Update for Kids under 6 - 1.12.24
- Preferred Diabetic Supply List Updated - 1.1.24
- Attention 340B Enrolled Pharmacies: Important Update on Dispensing Paxlovid to Vermont Medicaid Members 1.2.2024
- Important Change to Administration Fee for Vaccines -Effective 1.1.2024
2023
December
- POS System Outage Resolved 12.26.23
- Important Notice: Point of Sale (POS) Temporary Outage 12.26.23
- Preferred Drug List (PDL) Changes - Effective 1.1.2024
- Reminder: Vermont Medicaid Billing with Primary Commercial Insurance 12.11.23
November
- Important Coverage Changes to Prescription Biosimilar Drugs- Effective 1.1.2024
- COVID-19 Vaccine Coverage for Members Ages 3 and Older 11.9.23
- Changes to Coverage for Flovent® HFA and Flovent Diskus® 11.3.23
October
- Changes to Coverage for Ciprodex® Otic Suspension 10.19.23
- Covid-19 Vaccinations- 10.4.23
September
- Updates to Buprenorphine Prior Authorization Requirements - Effective 10.06.23
- Covid-19 Vaccinations 2023/2024 Season for Adults and Children - 9.22.23
- Covid-19 Vaccinations 2023/2024 Season for Adults 9.21.23
- Reminder: Vermont Medicaid Billing with Primary Commercial Insurance 9.18.23
- Auto Refill Language added to Pharmacy Provider Manual - 9.18.23
- Pharmacy Billing for Blood Pressure Monitors - 9.18.23
August
- Influenza (Flu) 2023_2024 Season - 8.18.23
- Pharmacy Newsletter - 8.9.23
- SCC13 Extension Due to Flooding - 8.9.23
July
- Changes to Incontinence Supplies for Medicaid - Effective 8.15.23
- Changes to Administration Fee for Vaccines - 7.28.23
- Important information for Medicaid Beneficiaries Extension - 7.25.23
- Important Information for Medicaid Beneficiaries - 7.14.23
June
- Over the Counter (OTC) Coverage Changes - Effective 8.1.23
May
April
- Prescription Signature Requirements - 04.11.23
March
- Early Refill Overrides with Submission Clarification Code (SCC) 13 - Effective 4.3.23
- Point of Sale (POS) Blackout Period Wednesday 3/29/23 - 3.21.23
- Pharmacy Newsletter March 2023
- 5% Copay Cap - Effective 4.1.23
- Important Changes to Administration Fee for Vaccines - Effective 3.15.23
February
- Pharmacy Benefit Provider Satisfactory Survey for Prescribers and Pharmacies
- Updates to Buprenorphine Prior Authorization Form - 2.14.23
- Update on Synagis® (palivizumab) Dispensing - 2.13.23
January
- Preferred Albuterol Sulfate Inhaler Availability - 1.27.23
- Differin Coverage Changes - Effective 1.1.23
- Change to Medicaid Copay - Effective 2.1.23
- Important Information on Reimbursement for High-Investment Carve-Out Drugs
2022
December
- Updates to Buprenorphine Prior Authorization Form - Effective 1.1.23
- Point of Sale (POS) Blackout Period - 12.16.22
- Change Healthcare Observance of Christmas and New Year Hours - 12.14.22
- 2023 Preferred Drug List (PDL) Changes - Effective 1.1.23
- Changes to Select Specialty Pharmacy Medication Dispensing - Effective 01.13.23
- Changes to Coverage for Diabetic Supplies - Effective 1.1.23
November
- Changes to Coverage for Select Outpatient Infusions - Effective 01.01.2023
October
- Pharmacy Newsletter - October 2022
- Synagis Season - Effective 10/10/2022
- Important Changes to Coverage for Naloxone Nasal Spray - Effective 10/7/22
- Buprenorphine Products Covered List -October 1, 2022
September
August
June
- Changes to Vpharm 2 and Vpharm 3 Coverage 6.28.22
- Pharmacy Newsletter 6.28.22
- Blood Glucose Test Strip Quantity Limit 6.7.2022
- Important Changes to Coverage for Etonogestrel/Ethinyl Estradiol Vaginal Ring 6.6.2022
- Point of Sale (POS) Blackout Period 6.3.2022
- Updated Letrozole Prior Authorization Request 6.2.2022
May
- Point of Sale (POS) Blackout Period 5.17.2022
April
March
- Important Information for Treatment Related to COVID-19 – 03/21/2022
- Buprenorphine Products Covered List - 03/18/2022
- Synagis Season Update 2021 to 2022 - 03/8/2022
- Pharmacy Newsletter - 03/02/2022
February
January
- Important Changes to Administration Fee for Vaccines - Effective 1/1/2022
- Update on Pharmacy COVID-19 Antigen Test Coverage - 01/28/22
2021
December
- Preferred Drug List (PDL) Changes - effective 01/01/22
- Pharmacy COVID-19 Antigen Test Coverage -12/16/21
November
- Clozapine REMS Requirements Change - 11/10/2021
- PrEP Medication Copay Waiver - 11/05/2021
October
- Pharmacy Newsletter - 10/29/2021
- Updated Billing Information for COVID-19 Vaccines - 10/14/2021
September
- Changes to Coverage for Continuous Glucose Monitoring (CGM) Systems and Supplies -Effective 10/01/21
- COVID-19 Vaccine Booster Billing - 09/07/2021
- Influenza (Flu) 2021/2022 season - 09/03/2021
- Synagis Atypical 2021 Summer Season - 09/02/2021
August
- COVID-19 Booster Vaccines - August 27, 2021
July
- Updated Age Edits for Codeine Pain and Cough Medication - Effective July 30, 2021
- Team Care Program- July23, 2021
- Pharmacist-Provided Tobacco Cessation services - Effective July 1, 2021
June
- Reminder: Vermont Medicaid Billing with Closed Primary Commerical Insurance - June 25, 2021
- Important Notice: Point of Sale (POS) Blackout Period - June 18, 2021
- Important Update on Hepatitis C Direct Acting Antivirals (DAAs) - June 15, 2021
- Important Notice: Point of Sale (POS) Blackout Period - June 14, 2021
May
April
- Important Information on Cumulative MME Limits - 04/28/21
- Important New Coverage of Omnipod DASH Insulin Pump - Effective 4/1/2021
March
February
January
- Pharmacy Newsletter 1/21/21
2020
December
- Information on COVID-19 Prior Authorization Extensions - 12/29/2020
- Changes to Coverage for Taltz - 12/28/2020
- Important Billing Information for COVID-19 Vaccines - 12/24/2020
- Preferred Drug List (PDL) January 1, 2021 Changes
- Additional Information on Pharmacist Enrollment for COVID-19 Vaccine Administration - 12/17/2020
- Changes to Preferred Albuterol Inhalers - 12/15/2020
- Pharmacist Enrollment Required for Reimbursement of COVID-19 Vaccine Administration 12/11/2020
November
- Attention Pharmacies and Pharmacists - Administration of Vaccines to Children 3-18 Years of Age 11/16/2020
October
- Smoking Cessation - 10/20/20
September
August
- Influenza (Flu) 2020/2021 Season Provider Notification
- Important Changes to Buprenorphine/Naloxone Tablets PDL Status - Effective 08/21/2020
July
- Important Update on Early Refill Overrides with Submission Clarification Code (SCC)=13 - Effective 7/24/2020
June
- Point of Sale (POS) Blackout Period Wednesday June 24,2020 - June 22, 2020
- Attention Pharmacies - Important Information about the DVHA Team Care Program - June 17, 2020
April
- Extension of Prior Authorizations - Response to the COVID-19 Emergency - effective 5/1/2020
- IMPORTANT: Discount Card Reminder
- Reminder to DME providers and Prescribers: Continuous Glucose Monitors (CGM) PA Waived
March
- Covid-19 Update - Effective 3/27/2020
- Important Pharmacy Information in Response to COVID-19
- COVID-19 - Retail Pharmacy Home Delivery Options - last updated 3/30/2020
January
- Changes to Refill Tolerance for Controlled Substances - Effective 01/09/2020
2019
December
- Preferred Drug List (PDL) Changes - Effective 01/01/2020
- Important Change to Medicare Claim Submission - Effective 01/01/2020
- Pharmacy Benefit Programs Provider Satisfaction Survey
November
- Pharmacy Newsletter
- Changes to Refill Limits - effective 11/01/2019
- Changes to Administration Fee for Vaccines - effective 11/08/19
October
- DVHA Preferred Drug List (PDL) - effective 10/11/2019
- Changes to Coverage for Continuous Glucose Monitoring (CGM) Systems and Supplies - Effective 10/1/2019
September
- Point of Sale (POS) Blackout Period on 9/21/2019
June
- IMPORTANT NOTICE: Point of Sale (POS) Blackout Period
- Vermont Medicaid Co-Pay Clarification - Pharmacy - June 17, 2019
- IMPORTANT NOTICE: Point of Sale (POS) Blackout Period - June 12, 2019
May
April
- 340B Claims Submission at Point of Sale (POS) for Pharmacies enrolled in the Vermont Medicaid 340B Program
- Important Changes to Sildenafil Coverage
- Important Changes to Coverage for Brand and Generic Formulations of Retin-A (tretinoin) and Differin (adapalene)
February
January
2018
December
- Pharmacy Benefit Update Newsletter - Preferred Drug List (PDL); Effective 1/1/19
- Hematopoietics: Colony Stimulating Factors - Effective 1/1/19
November
October
- Important Changes to Coverage for Actavis (Labeler 00591) Authorized Generic of Concerta** - Effective 1/1/19
- Synagis 2018/2019 Season - Prior Authorization
- Notice of Legislative Changes Affecting Medicaid
- Changes to Suboxone Film Prior Authorization Requirements Effective October 12th
September
August
July
- Important Changes to Coverage for Adderall and Generic Amphetamine/Dextroamphetatmine ER capsules
- Point of Sale (POS) Blackout Period Wednesday July 11th, 2018
May
April
- Important Changes to Coverage for Concentra and Actavis (Labeler 00591) Authorized Generic
- eWEBS Pharmacy Provider Portal - DVHA's new pharmacy benefits program
January
2017
December
- Naloxone - 2 preferred products on the PDL not requiring prior authorization requirement
- Pharmacy Benefit Newsletter Update - 2018 PDL Changes
- Important Changes to Coverage for Strattera - Effective 1/1/18
- Combivent and Respimat Moving to PA - Effective 1/1/18
- Important Changes to Coverage for Hepatitis C Agents - Effective 1/1/18
September
- Influenza 2017/2018 Season Updates
- Synagis 2017/2018 Season Updates
- IMPORTANT NOTICE: Point of Sale (POS) Blackout Period - Effective 9/23/2017
July
- IMPORTANT NOTICE: Point of Sale (POS) Blackout Period - Effective 7/19/2017
- IMPORTANT NOTICE: Point of Sale (POS) Blackout Period - Effective 7/19/2017
June
May
- Change Healthcare Common Helpdesk Questions
- POS System Testing on 5/17/2017
- Upcoming Preferred Drug List Changes - Effective 5/26/17
April
March
- IMPORTANT NOTICE: Point of Sale (POS) Blackout Period on 3/29/2017
- Frequently Asked Questions and Answers Related to the Pharmacy Reimbursement - Effective April 1, 2017
- Implementation of New Pharmacy Pricing Rules - Effective April 1, 2017
February
- HepC Criteria Changes 2/17/17 - Effective Immediately
- Survey of the Average Cost of Dispensing a Medicaid Prescription in the State of Vermont - February 08, 2017
- Contraceptive Days Supply Changes - 02/14/2017
January
- Fax Blast: Preferred Diabetic Supply List - Effective January 2017
- Pharmacy Benefit Update: PDL Changes - Effective 1/1/2017