Pharmacy Policies and Procedures

This section of our website is dedicated to providing Health Plan of San Joaquin/Mountain Valley Health Plan (“Health Plan”) providers and members with our pharmacy policies and procedures.

Jul 5th, 2024 PH05 Prior Authorizations Jul 5th, 2024 PH04 Pharmacy Therapeutics Committee Jul 5th, 2024 PH30-Medical-vs.-Pharmacy-Benefit Jul 5th, 2024 PH25-Pain-Medication-Requests-for-the-Terminally-Ill Jul 5th, 2024 PH23-Submission-of-Pharmacy-Benefit-Prior-Authorization-Claim Jul 5th, 2024 PH18-Practitioner-Communication Jul 5th, 2024 PH17-Member-Communication Jul 5th, 2024 PH14-Pharmaceutical-Safe-Use-Monitoring-of-Physician-Administered-Drugs Jul 5th, 2024 PH09 Step Therapy May 28th, 2024 PH32 Non-Opioid Pain Management (Simplified Chinese) May 28th, 2024 PH32 Non-Opioid Pain Management (Spanish) May 28th, 2024 PH32 Non-Opioid Pain Management Mar 1st, 2024 PH08 Managed Drug Limitations Mar 1st, 2024 PH10 Dispensing of Off-Label Prescriptions Mar 1st, 2024 PH11 Therapeutic Interchange Mar 1st, 2024 PH19 Nutritional Supplements for Medical Conditions Mar 1st, 2024 PH21 Drug Utilization Review

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