2026 Q1 Formulary Policy Updates
Catch up on Q1 2026 formulary policy updates, including important changes that may affect drug coverage, prescribing practices, and member access to medications.
Learn how to become part of our network and ensure your credentialing and registration are up-to-date
Search by Member ID, location, and plan type to find participating doctors and facilities
Find the right contact at MVP to address your questions
Get started with essential resources and guidance
Submit PAs for medical procedures and medications that require prior authorization
Check Member eligibility and review benefits
Submit claims electronically, track status, and review appeals
Check electronic payment statements and status
Sign in to your MVP Availity account to enhance preventive care—such as immunizations and checkups—for improved community health, using MVP Insights Powered by Arcadia
Access HEDIS tip sheets, compliance support documents and more supporting materials, to assist Providers in addressing gaps in care
Review: Medical, Payment, Genetic Testing, Laboratory, Pharmacy, and MVP Operations policies
View formularies, prior authorization forms, Medicaid and Medicare prescription benefits and more
Check out recent announcements and updates from MVP
Access clinical education, required trainings, attestations, and Provider support programs
Learn how to become part of our network and ensure your credentialing and registration are up-to-date
Search by Member ID, location, and plan type to find participating doctors and facilities
Find the right contact at MVP to address your questions
Get started with essential resources and guidance
Submit PAs for medical procedures and medications that require prior authorization
Check Member eligibility and review benefits
Submit claims electronically, track status, and review appeals
Check electronic payment statements and status
Sign in to your MVP Availity account to enhance preventive care—such as immunizations and checkups—for improved community health, using MVP Insights Powered by Arcadia
Access HEDIS tip sheets, compliance support documents and more supporting materials, to assist Providers in addressing gaps in care
Review: Medical, Payment, Genetic Testing, Laboratory, Pharmacy, and MVP Operations policies
View formularies, prior authorization forms, Medicaid and Medicare prescription benefits and more
Check out recent announcements and updates from MVP
Access clinical education, required trainings, attestations, and Provider support programs
Catch up on Q1 2026 formulary policy updates, including important changes that may affect drug coverage, prescribing practices, and member access to medications.
Catch up on Q1 2026 formulary policy updates, including important changes that may affect drug coverage, prescribing practices, and member access to medications.
Published January 2026
Below is a list of medications recently reviewed by the MVP Pharmacy and Therapeutics Committee. For coverage information regarding these medications, please review the MVP Formularies available at Pharmacy Information for Providers . For more detailed information regarding pharmacy changes, please review Provider FastFax Library or visit all policies MVP Health Care Medical Policy.
A list of formulary changes for Plan Year 2025 is available for review: 2025 Commercial and Marketplace Formulary Changes. Changes will take effect on the member’s pharmacy “Plan Year” start date.
| Brand name | Generic name |
|---|---|
| Xarelto | Rivaroxaban suspension |
| Eprontia | Topiramate solution |
| Dificid | Fidaxomicin tablet |
| Venofer injection; | Iron Sucrose |
| Arnuity Ellipta | Fluticasone Furoate |
| Saxenda | Liraglutide |
Review other articles in this issue regarding formulary, pharmacy policy, and medical policy updates.