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Microsoft word - healthnetnjrxpriorauthemployerletter022809.doc

February 28, 2009


Dear Valued Client,
At Health Net, we’re developing solutions that give people quality options that cost less. As this relates to pharmacy, we
are adding some drugs to our Prior Authorization list. Please note that this only affects Health Net members who are not
currently taking these drugs and who have a 3-Tier prescription drug plan. In addition, in most cases, it is the provider’s
responsibility to obtain the Prior Authorization (see details on attached member letter).
Effective April 1, 2009
We are moving Effexor XR®, Pristiq®, Cymbalta®, and Lexapro® – brand name antidepressant drugs – to the Prior
Authorization process as well as some other medications in the table below.
Angiotensin II Receptor Blockers (ARBs) & Renin
Anti Depressants:
Other Medications:

Effective June 1, 2009
The following four medications, which are covered as a medical benefit, will also require Prior Authorization, effective
June 1, 2009: Actemra, Cinryze, Numax, Nplate. These medications are typically administered in a health care provider’s
Health Net POS and PPO members will be notified via letter on March 1 of these changes and also receive the entire list
of drugs that require prior authorization if they have a 3-Tier prescription drug plan. Please see the attached member letter
and complete Prior Authorization list for your reference.
If you have any questions, please call our Account Services Unit at 1-800-384-1878. We value your partnership and are
here to help in any way we can.
General Segment Manager, Commercial Business Health Net of the Northeast, Inc. CT 58116 (2/09) Coverage is provided by subsidiaries of Health Net of the Northeast, Inc. and Health Net Life Insurance Co. Coverage may be provided by Health Net of New York, Inc. or Health Net Insurance of New York, Inc. in New York; Health Net of New Jersey, Inc. or Health Net Life Insurance Co. in New Jersey; and Health Net of Connecticut, Inc. or Health Net Life Insurance Co. in Connecticut. Health Net® is a registered service mark of Health Net, Inc. All rights reserved.


Microsoft word - surveya.doc

Enter today’s date __________________(mm/year) THE UNIVERSITY OF IOWA Membranoproliferative Glomerulonephritis (MPGN) Database Baseline Survey INSTRUCTIONS: Please answer the following questions to the best of your ability. The survey is to be completed by the individual diagnosed with MPGN (referred to as the Patient throughout the survey), if the Patient is age 18 or older

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