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PA Bulletin, Doc. No. 13-1263


Pharmacy Prior Authorization

[43 Pa.B. 4036]
[Saturday, July 13, 2013]

 The Department of Public Welfare (Department) announces it will add the following to the Medical Assistance (MA) Program's list of services and items requiring prior authorization:


 —Colony Stimulating Factors designated as preferred on the Department's Preferred Drug List (PDL).

 —Irritable Bowel Syndrome Agents designated as preferred on the Department's PDL.

 These prior authorization requirements apply to prescriptions dispensed on or after July 24, 2013.

 Section 443.6(b)(7) of the Public Welfare Code (62 P. S. § 443.6(b)(7)) authorizes the Department to add items and services to the list of services requiring prior authorization by publication of notice in the Pennsylvania Bulletin.

 The Department will issue MA Bulletins to providers enrolled in the MA Program specifying the procedures for obtaining prior authorization of prescriptions for each of the medications listed previously.

Fiscal Impact

 Currently there is no utilization of this class of drugs in the MA Program; therefore, it is anticipated that the prior authorization requirement will have no fiscal impact.

Public Comment

 Interested persons are invited to submit written comments regarding this notice to the Department of Public Welfare, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received within 30 days will be reviewed and considered for any subsequent revisions to these prior authorization requirements.

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).


Fiscal Note: 14-NOT-838. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 13-1263. Filed for public inspection July 12, 2013, 9:00 a.m.]

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