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PA Bulletin, Doc. No. 08-1386

NOTICES

DEPARTMET OF
PUBLIC WELFARE

Medical Assistance Program; Prior Authorization List

[38 Pa.B. 4038]
[Saturday, July 26, 2008]

   The Department of Public Welfare (Department) announces it will add early refills of prescriptions to the Medical Assistance (MA) Program's list of services and items requiring prior authorization, effective August 4, 2008.

   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 MA Program will require prior authorization of early refills of prescriptions dispensed on and after August 4, 2008. An ''early refill'' is a request for a refill when more than 25% of an earlier-dispensed medication would remain when taken in compliance with the directions and quantity prescribed.

   The Department will issue an MA Bulletin to providers enrolled in the MA Program, specifying the procedures for obtaining prior authorization of early refills for prescriptions.

Fiscal Impact

   It is anticipated that this change will result in savings of $5.413 million ($2.528 million in State funds) in the MA-Outpatient Program in Fiscal Year (FY) 2008-2009. Annualized savings of $6.521 million ($3.040 million in State funds) are estimated for FY 2009-2010.

Public Comment

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

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

ESTELLE B. RICHMAN,   
Secretary

   Fiscal Note: 14-NOT-565. No fiscal impact; (8) recommends adoption. Implementation of this notice is expected to generate $2.5 million savings in FY 2008-2009.

[Pa.B. Doc. No. 08-1386. Filed for public inspection July 25, 2008, 9:00 a.m.]


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