MedicaidCoverageMedium impact
Brand Invega®, Sabril®, Lamictal®, and Strattera® required starting January 11, 2021
Oregon Health Plan·OR · Psychiatry, Neurology, Pediatrics +2 more·Provider
Effective date
Jan 11, 2021
We identified it
Jun 20, 2026
Summary
Starting January 11, 2021, Oregon Health Plan (OHP) fee-for-service will require pharmacies to dispense brand-name medications (Invega®, Sabril®, Lamictal®, and Strattera®) instead of generic equivalents. Claims for generic versions of these specific medications will be denied unless prior authorization is obtained.
Action Required
Effective January 11, 2021: Medical billing teams must ensure that Oregon Health Plan (OHP) fee-for-service patients receive brand-name prescriptions for Invega®, Sabril®, Lamictal®, and Strattera® instead of generic equivalents. If generic versions are medically necessary, providers must obtain prior authorization by calling the Oregon Pharmacy Call Center at 1-888-202-2126 before dispensing. Update EMR templates to flag these medications for OHP FFS patients to prevent claim denials.