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Delivering quality medical services to our members is the hallmark of EHP. To maintain such high standards
of excellence we rely on partnerships with quality care providers.
We want all EHP members to have a healthy start. To see the Provider Preventive Guidelines, click here
News
MCNET is Moving!! This spring JHHC is moving McNet from www.jhhc.com to www.jhhcmcnet.com.
If your office currently bookmarks a direct link to McNet, please be sure to change your bookmark by May 31, 2009.
Want to get paid even faster? Did you know that Johns Hopkins HealthCare now offers electronic
payments to its providers? Electronic Funds Transfer (EFT) is easy to set up and once complete guarantees
a quicker reimbursement. For more information e-mail (Electronicpayments@jhhc.com) or call (888-895-4998)
today.
Chester River Hospital Members Only:
Johns Hopkins HealthCare is pleased to announce that the University of Maryland Hospital and its
affiliated University Physicians, Inc. practices have been added to the Chester River Hospital
Center EHP network. To review a full list of practices along with phone numbers, click here.
EHP: Preferred Drug List
The following updated drug list is provided by CVS Caremark. This CVS Caremark Performance Drug
list is a guide within select therapeutic categories for clients, EHP plan participants and
providers. Generics should and will be considered before prescribing. A full listing along with
instructions on prescribing various drugs is provided. Click Here for the listing.
Care Management Programs
EHP recognizes that sometimes members need assistance in managing their health and offers a
number of programs and initiatives to address those needs. Perhaps you have a patient with a
chronic health condition, such as asthma, diabetes, high blood pressure or coronary heart disease.
Or maybe a patient could use the services of a coach to help develop a personal action plan to
loose weight, reduce stress, or stop smoking. Help is available.
Your
Partner In Health.
FREE Medication with Case Management:
For those with Asthma and/or Diabetes
If your patient is an EHP member with Johns Hopkins Health System Corporation, Johns
Hopkins Bayview Medical Center, or Howard County General Hospital, he/she is eligible
for a co‐pay waiver on diabetic and asthmatic medications. As an EHP member, your
patient will be required to engage with a case manager to learn about improving their
self‐management techniques and living a healthier lifestyle.
For more information, call Johns Hopkins HealthCare Care Management at 1‐800‐957‐9760 or e‐mail healthyhopkins@jhhc.com and ask for a copy of the Medication Co‐Pay
Waiver Agreement. It provides a full list of medications, information on the benefit, and
details regarding the member’s responsibilities. For example, a patient may be required
to regularly report routine test results and/or discuss their progress with a personal care
nurse assigned to them.
Call 1‐800‐957‐9760 today to help your patient improve their health and save money!
Pharmacy News
General information about pharmacy benefits can be found in our FAQs.
Representatives from Employer Health Programs (EHP) and Johns Hopkins Hospital/Johns Hopkins Health System
Corporation, Bayview Medical Center, and Howard County General Hospital met recently to identify ways to
improve health plan benefits and develop programs that promote safety and healthy lifestyles while being
cost effective. A letter detailing
pharmacy benefits changes was
mailed to employees in late October. To review the letter, FAQs about the changes, or the impacted list of drugs, click on the following links.
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Prior Authorization
Certain medications require prior-authorization before coverage is approved, to ensure medical necessity,
clinical appropriateness and/ or cost effectiveness. Coverage of these drugs is subject to specific
criteria approved by physicians and pharmacists on the Johns Hopkins Health Care Pharmacy and Therapeutics
Committee. Established criteria are based on medical literature, physician expert opinion, and FDA approved
labeling information. Your doctor can request prior authorization for you by contacting Caremark.
For a list of drugs that
currently require prior-authorization click here. This list is subject to change without notice and is not
applicable to all EHP groups. Consult your SPD to determine if your plan is subject to this list.
Quantity Edits
Certain medications have specific dispensing limitations for quantity and maximum dose. These dispensing
limitations are based on generally accepted guidelines, drug label information approved by the Food and
Drug Administration (FDA), current medical literature and input from a committee of physicians and
pharmacists. The three types of quantity limits include the following:
- Coverage limited to one dose per day for drugs that are approved for once daily dosing
- Coverage limited to specific number of units over a defined time frame
- Coverage limited to approved maximum daily dosage
When medically necessary, an exception to quantity limits can be requested. This list of drugs is subject to
change without notice and is not applicable to all EHP groups. For a list of drugs that currently have quantity
limits click here. Consult your SPD to determine if your plan is subject to this list.
FAQs about Prior-Authorization and Quantity Limits
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| Forms |
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Referral Form
Treatment Plan Form
Group Disability Claim Form
Group Disability Claim Form (Salary)
Pharmacy Prior Authorization Form
Dental Claim Form
Maryland Uniform Credentialing Forms
ADA Claim Form
View Complete Forms List
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| Guidelines |
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EHP Quick Reference Guide
Referral Guidelines
Appeals Response Time Grid
EHP Sudden and Serious Criteria List
EHP Provider Manual
Anesthesia Guidelines
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| Pharmacy |
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Pharmacy
The Johns Hopkins Employer Health Program (EHP) administers pharmacy benefits for the following groups: Johns Hopkins Hospital/Health Systems, Johns Hopkins Bayview Medical
Center, AON Corporation, Chester River Hospital Center, Broadway Services Incorporated, and the Johns Hopkins University Student Health Program. As a
reference for drug selection providers may use the 2008 formulary. For more information on generic substitutions, injectable drugs choices, and prior authorizations
click here.
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| McNet |
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Providers can use McNet to lookup member eligibility or claim status. To Login click here.
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| HEDIS |
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The Health Plan Employer Data and Information Set (HEDIS) is a nation-wide collaborative effort to gather data on
specific performance measures. Johns Hopkins HealthCare LLC (JHHC) on behalf of Johns Hopkins Employer Health
Programs (EHP) will be collecting HEDIS data on a sample of members beginning July 2007. View the EHP Measure
Learn more about the HEDIS initiative.
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| Hopkins Across The Board Newsletter |
Hopkins Across the Board is a combined quarterly newsletter for providers that offers insight into all of
Johns Hopkins HealthCare’s lines of business, including Employer Health Programs (EHP). It is
produced by the External Affairs and Communications Department, Johns Hopkins HealthCare LLC.
The newsletter contains provider updates, important phone numbers, pertinent health articles,
drug lists and more. If you have information you’d like to submit to Hopkins Across the Board,
please e-mail dchase@jhhc.com or contact your Network Manager at 410-762-5385 or 888-895-4998.
Spring 2009 Newsletter
Winter 2008 Newsletter
Fall 2008 Newsletter
Summer 2008 Newsletter
Spring 2008 Newsletter
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| Quick Contacts |
EHP Customer Service
(M - F 8am - 5pm)
EHP Care Management
Short-Term Disability
Dental
Pharmacy (Mail Order Only)
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1-800-261-2393
1-800-261-2421
410-762-5312
1-800-261-2393
1-800-213-0879
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Full Contact List
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