Payor Policies (by State)

Alabama

Medicare Part B Carrier

• Cahaba Government Benefits LLC

Medicaid

Alaska

Medicare Part B Carrier

• Noridian Administrative Services

Medicaid

Arizona

Medicare Part B Carrier

• Noridian Administrative Services

Medicaid

State Pharmacy Assistance Program (SPAP)

Arkansas

Medicare Part B Carrier

• PBSI Medicare Services

Medicaid

California

Medicare Part B Carrier:

• NHIC, Corp.

Medicaid

Colorado

Medicare Part B Carrier

• Trailblazer Health Services

Medicaid

Connecticut

Medicare Part B Carrier

• First Coast Service Options, Inc.

Medicaid

State Pharmacy Assistance Program (SPAP)

Delaware

Medicare Part B Carrier

• Highmark Medical Services

Medicaid

State Pharmacy Assistance Program (SPAP)

District of Columbia

Medicare Part B Carrier

• Highmark Medicare Services

Medicaid

Florida

Medicare Part B Carrier

• FirstCoast Service Options, Inc.

Medicaid

Georgia

Medicare Part B Carrier:

• Cahaba Government Benefits LLC

Medicaid

Hawaii

Medicare Part B Carrier

• Noridian Administrative Services

Medicaid

Idaho

Medicare Part B Carrier

• CIGNA Government Services Part B

Medicaid

Illinois

Medicare Part B Carrier

• Wisconsin Physicians Service

Medicaid

State Pharmacy Assistance Program (SPAP)

• www.illinoiscaresrx.com
• www.cbrx.il.gov/

Indiana

Medicare Part B Carrier

• National Government Services

Medicaid

State Pharmacy Assistance Program (SPAP)

• www.in.gov/fssa/ompp/4248.html
• www.rxforindiana.org

SPAP 1

Iowa

Medicare Part B Carrier

• WPS Medicare

Medicaid

Kansas

Medicare Part B Carrier

• WPS Medicare

Medicaid

State Pharmacy Assistance Program (SPAP)

Kentucky

Medicare Part B Carrier

• National Government Services

Medicaid

Louisiana

Medicare Part B Carrier

• Pinnacle Business Solutions, Inc.

Medicaid

Maine

Medicare Part B Carrier

• NHIC, Corp.

Medicaid

State Pharmacy Assistance Program (SPAP)

Maryland

Medicare Part B Carrier

• Highmark Medicare Services

Medicaid

State Pharmacy Assistance Program (SPAP)

• www.marylandspdap.com
• www.dhmh.state.md.us/mma/mpap

Massachusetts

Medicare Part B Carrier

• NHIC, Corp.

Commonwealth Care

Medicaid

SPAP

State Pharmacy Assistance Program (SPAP)

Michigan

Medicare Part B Carrier

• WPS Medicare

Medicaid

Minnesota

Medicare Part B Carrier

• WPS Medicare

Medicaid

Mississippi

Medicare Part B Carrier

• Cahaba Government Benefits LLC

Medicaid

Missouri

Medicare Part B Carrier (Northwest)

• WPS Medicare

Medicare Part B Carrier (Eastern)

• WPS Medicare

Medicaid

State Pharmacy Assistance Program (SPAP)

Montana

Medicare Part B Carrier

• Noridian Administrative Services

Medicaid

State Pharmacy Assistance Program (SPAP)

Nebraska

Medicare Part B Carrier

• WPS Medicare

Medicaid

Nevada

Medicare Part B Carrier

• Noridian Administrative Services

Medicaid

State Pharmacy Assistance Program (SPAP)

New Hampshire

Medicare Part B Carrier

• NHIC, Corp.

Medicaid

New Jersey

Medicare Part B Carrier

• National Government Services

Medicaid

State Pharmacy Assistance Program (SPAP)

• www.state.nj.us/health/seniorbenefits/pbp/paad-home.shtml
• www.state.nj.us/health/seniorbenefits/documents/seniorgold_factsheet.pdf

New Mexico

Medicare Part B Carrier

• Pinnacle Business Solutions

Medicaid

New York

Medicare Part B Carrier (Queens County)

• GHI Medicare

Medicare Part B Carrier (Southwest NY)

• National Government Services

Medicare Part B Carrier (Upstate)

• Upstate Medicare Division

Medicaid

State Pharmacy Assistance Program (SPAP)

North Carolina

Medicare Part B Carrier

• CIGNA Government Services Part B

Medicaid

State Pharmacy Assistance Program (SPAP)

North Dakota

Medicare Part B Carrier

• Noridian Administrative Services

Medicaid

Ohio

Medicare Part B Carrier

• Palmetto GBA

Medicaid

Oklahoma

Medicare Part B Carrier

• Trailblazer Health Services

Medicaid

Oregon

Medicare Part B Carrier

• Noridian Administrative Services

Medicaid

Pennsylvania

Medicare Part B Carrier

• Highmark Medicare Services

Medicare Local Coverage Decisions (LCDs)

Medicaid

State Pharmacy Assistance Program (SPAP)

Rhode Island

Medicare Part B Carrier

• Pinnacle Business Solutions

Medicaid

• State Pharmacy Assistance Program (SPAP)

South Carolina

Medicare Part B Carrier

• Palmetto GBA

Medicaid

State Pharmacy Assistance Program (SPAP)

South Dakota

Medicare Part B Carrier

• Noridian Administrative Services

Medicaid

Tennessee

Medicare Part B Carrier

• CIGNA Government Services Part B

Medicaid

Texas

Medicare Part B Carrier

• Trailblazer Health Enterprises, LLC

Medicaid

Utah

Medicare Part B Carrier

• Noridian Administrative Services

Medicaid

Vermont

Medicare Part B Carrier

• NHIC, Corp.

Medicaid

State Pharmacy Assistance Program (SPAP)

Virginia

Medicare Part B Carrier

• Trailblazer Health Enterprises, LLC

Medicaid

State Pharmacy Assistance Program (SPAP)

Washington

Medicare Part B Carrier

• Noridian Administrative Services

Medicaid

West Virginia

Medicare Part B Carrier

• Palmetto GBA

Medicaid

Wisconsin

Medicare Part B Carrier

• Wisconsin Physicians Service

Medicare Local Coverage Decisions (LCDs)

Medicaid

State Pharmacy Assistance Program (SPAP)

Wyoming

Medicare Part B Carrier

• Noridian Administrative Services

Medicaid

State Pharmacy Assistance Program (SPAP)

Puerto Rico

Medicare Part B Carrier

• Triple-S