New Medicaid Preferred Drug Program Prior Authorization (info updated 8/2/2007)

 

Faxing is an easy way to get prior authorization. You can give your patient the prescription without PA#, and tell him/her to go to the pharmacy the next day. Be sure to write on the Rx that a Fax PA has been sent, this way the pharmacist knows to call Medicaid to get the PA number.

 

The 2nd way to get prior authorization is to call 1-877-309-9493, be sure to have your or your attending’s License # available.  Once you have the approval #, write that on the prescription.  That Rx will be active for refills for 6 months.  Click here for the link to Medicaid Preferred Med Formulary, and other information about the prior approval process.

 

Click here for a list of Medicaid preferred drugs, versus those that need telephone prior authorizations.

 

  1. For a updated list of preferred drugs https://newyork.fhsc.com/downloads/providers/NYRx_PDP_PDL.pdf

 

  1. For new Fax prior authorization sheet and instructions/procedures: https://newyork.fhsc.com/providers/PDP_forms.asp the competed fax forms should be faxed to 1 800 268 2990.

 

  1. Detailed instruction for obtaining Prior Authorizaton see: https://newyork.fhsc.com/downloads/providers/NYRx_PDP_PA_procedures_for_prescribers.pdf

 

  1. Frequent asked question about Preferred Drug Plan see: http://www.health.state.ny.us/health_care/medicaid/program/update/2006/jul2006.htm#phar

 

  1. For other drugs like Zyvox, Rivatio click info here https://newyork.fhsc.com/providers/CDRP_forms.asp

 

 

note:
What is new with the mid-October phase of the Preferred Drug list roll out is that Prevacid and Nexium have been added to the preferred PPI list. Medications such as Oxycontin, Flonase, and Tricor now require prior authorization. Tricor can be substituted by using Lofibra which is another fenofibrate brand.