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Medical Injectables Program Updates: Additional Medications and INFLECTRA

As previously announced, effective May 1, 2017, additional injectable medications will be included as part of our Medical Injectables Program (MIP) administered by Magellan Rx Management℠.

Beginning with services to be provided on and after May 1, 2017, Magellan Rx Management will conduct medical necessity and appropriateness reviews (MNARs) for additional injectable medications that are administered in a freestanding or hospital-based dialysis center, an outpatient facility, a patient's home or a physician's office.¹

Review the list of additional injectable medications.

The complete list of injectable medications that currently require MNAR as part of the MIP is also available.

  • INFLECTRA® to be added to MIP effective June 1, 2017

  • In addition to the previously announced additional injectable medications, effective June 1, 2017, INFLECTRA (infliximab dyyb) will also be included as part of our MIP.

  • FDA-approved INFLECTRA is biosimilar to Janssen Biotech, Inc.'s REMICADE® (infliximab) and has only been available in the U.S. since late November 2016.

If you have questions, please contact your Network Specialist.

¹ Medical necessity and appropriateness review is not required for injectable medications that are administered during an inpatient stay, or in an Emergency Room setting or Observation Room setting. For medical Injectable services rendered in the patient&pos;s home, call 1-855-243-3321 for participating Horizon Care@Home providers to obtain pre-service determination.

REMICADE® is a registered trademark of Janssen Biotech, Inc.

INFLECTRA® is a registered trademark of Pfizer Inc.

Magellan Rx Management is a service mark of Magellan Health, Inc.

Published on: April 28, 2017, 11:17 a.m. ET
Last updated on: June 2, 2021, 14:56 p.m. ET