The AmeriHealth Direct Ship Drug Program is a service that allows our network providers to order select office-based drugs eligible for coverage under the medical benefit without paying an additional fee. AmeriHealth works directly with our specialty drug vendors to handle processing, payment, and delivery.

Direct ship drug request form updates

We have updated the general drug request form, which is used to request all direct ship drugs that do not have a specific order form.

In addition, updates have been made to the following five direct ship request forms for specific drugs, which reflect new medical policy criteria or new formulation options:

• Hydroxyprogesterone Caproate
• Nucala^? (mepolizumab)
• Stelara^? (ustekinumab)
• Viscosupplementation (hyaluronate acid products) (Orthovisc^?, Synvisc^?, Synvisc-One^?, Euflexxa^?, Gel-One^?, GelSyn-3^TM, GenVisc 850^?, Hyalgan^?, Hymovis^?, Monovisc^?, Supartz^{?, VISCO-3TM, Durolane?, and TriViscTM)}
• Xolair^? (omalizumab)

If your office has previous versions of these forms, please discard them and use the updated forms, which are available for download on the AmeriHealth New Jersey or AmeriHealth Pennsylvania websites and can be identified by the April 2018 date at the bottom-right corner.

New direct ship drug request forms

New forms have been created for the following drugs:

• Vivitrol^? (naltrexone)
• Fasenra^TM (benralizumab)

These forms are available for download on the AmeriHealth New Jersey or AmeriHealth Pennsylvania websites. Please add these new direct ship request forms to your office?s form library.

For more information

For more information on the Direct Ship Drug Program, including the list of medical benefit drugs available under this program, or to download the forms, go to the Direct Ship Drug Program web page for AmeriHealth New Jersey or AmeriHealth Pennsylvania.