Medicaid Health Plan Carve-out

This webpage provides links to information on Medicaid program covered services not covered by the Medicaid Health Plans (MHPs).

• Medicaid Health Plan Injectable Drugs and Biologicals Carve-out
  A list of specific physician-administered Medicaid program covered drugs carved out from MHP coverage. They will be reimbursed as a Fee-for-Service (FFS) benefit for all FFS and MHP enrollees.
   
• Medicaid Health Plan Pharmacy Program Carve-out
  A link to the Medicaid Pharmacy Benefits Program webpage.  Magellan Medicaid Administration, Inc. maintains a list of Medicaid program covered pharmacy products that are carved out of the MHPs.
   
• PIHP/CMHSP Physician Injectable Drugs Carve-out
  A list of specific physician-administered injectable drugs available through the PIHP/CMHSP clinic to eligible beneficiaries enrolled in Medicaid.  They will be reimbursed as an FFS benefit for all FFS and MHP enrollees.
   
• Drugs and Therapeutics Carved Out of Hospital Diagnosis Related Group (DRG) Payment
• Additional Resources
• Contact Information