On October 1, the Ohio Department of Medicaid (ODM) streamlined prescription claims processing for all Medicaid recipients. Gainwell Technologies, the new single pharmacy benefit manager, has a website with a repository of formulary information including an over-the-counter (OTC) covered medication list.
Partners For Kids will continue to maintain a pediatric focused Unified Preferred Drug List (UPDL) that is now updated to include some of the Gainwell resources.
Gainwell does not have electronic PA integration with third party vendors at this time and their preferred method of PA submission is via fax, using the fillable form. Below are additional resources, including the fillable form, to help you navigate this new rollout.
Gainwell Technologies links:
- Homepage: Gainwell Homepage
- UPDL tools and downloads: General Tools
- Drug Search tool: NDC Search Tool
- Prior authorization submission process: User Guides
- Prior authorization fillable form: Forms
Gainwell Technologies contact information:
Phone: (833)-491-0344
Fax: (833)-679-5491