TAILIEUCHUNG - INDEPENDENT HEALTH’S Child Health Plus® 2013 Drug Formulary Updated January 2013

The Environmental Health program licenses and inspects restaurants, motels, RV parks, pools, spas, and organizational camps. Our environmental health specialists teach and certify food handlers and also provide food service manager training. To protect from food-borne illnesses, we license and inspect temporary food events that are open to the public. We also investigate reported cases of food- borne and water-borne illnesses. We monitor over 70 small public water systems in our county. For a fee, we can perform assessments of septic and water systems for loan transactions. We also inspect correctional facilities, school kitchens, and daycare centers | INDEPENDENT HEALTH S Child Health Plus 2013 Drug Formulary Updated January 2013 This drug formulary lists covered generic and brand name drugs under our MediSource Medicaid Prescription Drug Plan. Covered generic drugs appear in lower case covered brand name drugs start with a capital letter. Covered over-the-counter drugs must have a prescription. When a generic drug becomes available for a formulary brand name drug the generic will be covered and the brand will become non-formulary and will require prior authorization to be covered. Independent Health makes every attempt to provide you with as accurate a listing of drugs as possible. However the list of drugs and availability of generics can change frequently. Please discuss any questions you may have about the formulary with your physician. In order to ensure the safest and most appropriate care Independent Health s drug coverage criteria is limited to medically-accepted indications based on FDA approved labeling and guidelines that is not otherwise excluded from New York State Medicaid. Independent Health also relies on support by one or more official compendia citations to provide guidelines when a drug or indication is not FDA approved. Compounded prescriptions medications that are not commercially manufactured must be prepared by a participating pharmacy and contain at least one prescription component. The dispensing pharmacy is required to submit for prior approval and when covered will take the applicable copayment. Coverage is provided in accordance with our Compounding Drug Products Policy. Bulk products and powders are excluded from coverage because they are not prescription drug products that are approved under sections 505 505 j or 507 of the Federal Food Drug and Cosmetic Act. Replacement of lost stolen or damaged medications is the responsibility of the member. ER Scripts are limited to a 10 day supply. Prior authorization cannot be used to obtain early refills for lost stolen or damaged medication

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