To view the current drug policy, please click the link below:
To view the full list of active HMSA Specialty Medical Drug Policies, please click here.
To view previous versions of this policy that are now expired, please click on the links below:
As of 10/1/2015, please click here for previous versions of this policy.
|Rev#:||Date:||Nature of Change:|
|0.5||07/10/2012||The following procedure/CPT/HCPCS codes are included in this policy: J9305|
|1.0||07/05/2012||Added a new link to the new, current policy version and moved the previous link into the "previous" section.|
|1.1||05/07/2013||Added a link to the 90-day notice version of this policy, effective September 1, 2013.|
|1.2||09/25/2013||Replaced the link to the 90-day notice version of this policy with the new current link and moved the previous version into the "previous" section.|
|1.3||07/21/2014||Added a link to the new, current version of this policy and moved the previous version into the "previous" section.|
|1.4||11/06/2014||Replaced the link to the 90-day notice with a link to the new, current version of this policy and moved the previous version into the "previous" section.|
|1.5||05/26/2015||Added a link to the 90-day notice version of this policy, effective October 1, 2015|
|1.6||06/30/2015||Added link to new 90-day notice. Effective 10/1/15.|
|1.7||9/24/2015||Added a link to the clean, current policy and moved the expired policy into the "previous" section.|
|1.8||03/02/2018||Updated the title of the current policy link to reflect the current policy effective date. Added the link to the previous (archived) versions of the policy on caremark.com.|
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