2024 Q3 Drug formulary change notification

  • 08/30/2024

Key points

  • Hennepin Health is making several changes to its drug formulary for Q3 2024. 
  • The changes apply to all Hennepin Health members.
  • The updated full drug formulary is available online on Hennepin Health's forms/documents page. A printed copy can be obtained by calling Provider Services at 612-596-1036 (select option 2).

 

Background

Hennepin Health has made several changes to the drug formulary. These changes apply to Hennepin Health-PMAP, Hennepin Health-MNCare and Hennepin Health-SNBC members. Members who are directly impacted will receive notification of the changes. The updated full drug formulary is available on Hennepin Health’s website. A printed copy can be obtained by calling Provider Services at 612-596-1036 (select option 2). 

Effective Sept. 1, 2024, these utilization management (UM) requirements of quantity limits (QL) were added:

  • Dexcom G6 Transmitter, QL = 1 transmitter/90 days
  • Dextroamphetamine ER Cap 5 mg, QL = 2 caps/day, only one strength per month
  • Dextroamphetamine ER Cap 10 mg, QL = 2 caps/day, only one strength per month
  • Dextroamphetamine ER Cap 15 mg, QL = 2 caps/day, only one strength per month
  • Desonide oint, QL = 60 gm/30 days

Resources

  • Hennepin Health Provider Services: 612-596-1036 (select option 2) 
  • Hennepin Health website: www.hennepinhealth.org
 
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