Medical Injectable Drug Program

Highmark utilizes Free Market Health to support the Medical Injectable Drug (MID) Program.

Physicians are able to buy and bill for all drugs listed in the MID Program, as all drugs are considered voluntary across all regions, for all lines of business.

If a physician chooses not to buy and bill, Free Market Health (FMH) will assign a home infusion therapy (HIT) provider or medical specialty pharmacy that is a part of the FMH-contracted network. Providers cannot directly send the prescription to a specialty pharmacy of their choice, as they will receive a medical claims rejection.

More information around Free Market Health

List of Drugs Included in the Program

Below is the necessary information that should be provided on the prior authorization to limit and reduce the additional outreaches to the Provider's office.

• Patient name, address, date of birth
• Date needed
• Diagnosis code in ICD-10 format
• Patient weight
• Prescription Insurance Information
• Drug name and strength
• Directions
• Quantity
• Refills
• MD Signature, address, and contact information
• Date written
• Allergies, Medical conditions, and concurrent medications
• Prior authorization numbers or information if already obtained
• Any other additional information required