Policies and forms
HealthPartners looks to clinical experts to determine what to include in the HealthPartners Preferred Drug Lists (Formularies). These decisions in are made by the physicians and pharmacists on our Pharmacy and Therapeutics Committee. The Committee develops, manages, updates and administers our preferred drug lists.
For certain drugs, the Pharmacy and Therapeutics Committee has developed criteria that must be met before the drugs will be approved for coverage, even if it is on the preferred drug lists. These drugs are noted on the preferred drug lists with a "PA" after their names.
- Site of Care Request for Information Form
- Minnesota Uniform Prior Authorization and Formulary Exception Form
- New Drug Request Form
- Fraud, Waste and Abuse
- Hepatitis C Drug Request Form
- High Risk Medications and Alternatives for Older Adults
- General Prior Authorization Form
- Growth Hormone Statement of Medical Necessity
- Pharmacy and Therapeutics Committee Policies and Procedures
- Chronic Inflammatory Disease Biologic Annual Reauthorization & High Dose Request Form