Pennsylvania Code
Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

• No statutes or acts will be found at this website.

The Pennsylvania Bulletin website includes the following: Rulemakings by State agencies; Proposed Rulemakings by State agencies; State agency notices; the Governor’s Proclamations and Executive Orders; Actions by the General Assembly; and Statewide and local court rules.

PA Bulletin, Doc. No. 17-1986

DEPARTMENT OF
HUMAN SERVICES

Pharmacy Prior Authorization

[47 Pa.B. 7392]
[Saturday, December 2, 2017]

 The Department of Human Services (Department) announces it will add Austedo (deutetrabenazine), Brineura (cerliponase alfa), Ingrezza (valbenazine) and Xermelo (telotristat ethyl) to the Medical Assistance (MA) Program's list of services and items requiring prior authorization.

 Section 443.6(b)(7) of the Human Services 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 all prescriptions for Austedo (deutetrabenazine), Brineura (cerliponase alfa), Ingrezza (valbenazine) and Xermelo (telotristat ethyl). These prior authorization requirements apply to prescriptions dispensed on or after January 8, 2018.

 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 previously listed.

Fiscal Impact

 These changes are estimated to result in minimal savings in the MA Fee-for-Service Program.

Public Comment

 Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, 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).

TERESA D. MILLER, 
Acting Secretary

 Fiscal Note: 14-NOT-1189. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 17-1986. Filed for public inspection December 1, 2017, 9:00 a.m.]


No part of the information on this site may be reproduced for profit or sold for profit.

This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.