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Stay informed about Fidelis Care policies and updates, and keep up to date on upcoming provider office hours and trainings.
Do you need assistance? Please visit our Contact Provider Relations page to find your designated Provider Relations Specialist.
Fidelis Care has made changes to our Medicaid Managed Care, Child Health Plus (CHP), and HealthierLife (HARP) Formulary effective July 1, 2022. Some of the changes relate to quantity limitations, authorization requirements, as well as drugs being removed and added to the formulary.
Part I: Formulary Additions & PA/ST/QL Removals
Drug/Product
Action
Effective Date
Hydromorphone ER tablet
Add with ST of a formulary long-acting agent
07/01/2022
Lidocaine 5% patch
Add with QL of 90/25
Moxifloxacin ophthalmic
Add with QL of 6ml/25
Norvir 100mg Powder
Add; PA required for members 18 and over
05/01/2022
Omnipod 5
Add with PA
Part II: Formulary Removals & PA/ST/QL Additions
Drug
Formulary Alternatives
Memantine ER tablet
Add QL of 30/25
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To submit prior authorization request types, use the Fidelis Care provider portal.
Members in our Medicaid Managed Care, HealthierLife (HARP), Fidelis Care at Home, and Wellcare Fidelis Dual Plus plans have access to a network of service providers to identify and address needs such as housing, food, transportation, and more.
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