Medicaid

Banner Health Plans (BHP) provides updates to the drug lists periodically. Below are the AHCCCS Drug Formulary and the Pharmacy Prior Authorization Criteria. 

AHCCCS Drug Formulary | Effective October 1, 2024

Pharmacy Prior Authorization Criteria (Guidelines) | Effective October 1, 2024

Pharmacy Prior Authorization Criteria (Guidelines) | Effective November 1, 2024

Banner Medicaid Internal Criteria | Effective November 1, 2024