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Open Enrollment 2021

ADAP Documents

Nevada ADAP Formulary

  • ADAP Formulary #47 Alpha Generic
  • ADAP Formulary #47 Drug Class
  • ADAP Formulary #47 Alpha Brand

Policy and Procedures

  • 16-11 PP Payer of Last Resort Exemptions
  • 16-12 PP Marketplace Insurance Special Enrollment Periods
  • 16-14 PP Tax Reconciliation Policy
  • 17-04 PP Health Insurance Decision Tree
  • 17-21 PP Lost Stolen and Vacation Override
  • 19-01 PP Medical Advisory Committee Policy and Procedures 
  • 19-02 PP Referrals for Medication or Insurance Assistance
  • 19-07A PP NPAP Acknowledgement Form APTC
  • 19-07B PP NPAP Acknowledgement Form Non-APTC

Forms

  • Prior Authorization for Hepatitis C Treatment Regimens
  • Prior Authorization for Trogarzo Form
  • Prior Authorization for Egrifta Tesamoralin Form

COVID 19 Information

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