New Prior Authorization Process for Medicaid

In the recently released New York State Medicaid Update (August 2012), the Department of Health announced a new web portal to initiate fee for service pharmacy prior authorization requests for prescribers, effective September 6, 2012.

The application is accessible through the site.  Prior authorization will also continue to be available through the Magellan Clinical Call Center at 877-309-9493.

Hopefully, this initiative will streamline the prior authorization process for providers, thereby helping to ensure that Medicaid recipients receive medications as prescribed by their health care provider in timely fashion.

On the Medicaid managed care side, advocacy groups are still awaiting Executive action on A.10248/S.7384, which would create a standardized prior authorization form for use by prescribers.  If signed into law, this bill will greatly simplify the prior authorization process for prescribers and pharmacists, allowing them more time to devote to actual patient care. Currently, prescribers and pharmacies are forced to navigate through the processes of 20 different managed care plans.

Groups and individuals are encouraged to write to Governor Cuomo in support of this legislation.

Letters can be addressed to:

Governor Andrew M. Cuomo

Executive Chamber

State Capitol

Albany, NY 12224

-Jaime Venditti, 9/7/12