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PA Bulletin, Doc. No. 11-1195


Pharmacy Prior Authorization

[41 Pa.B. 3942]
[Saturday, July 16, 2011]

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

 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 all prescriptions for Nuedexta and Makena dispensed on or after July 11, 2011.

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

Fiscal Impact

 It is estimated that the change will result in savings in the MA Outpatient Program of approximately $0.862 million ($0.386 million in State funds) in Fiscal Year 2011-2012.

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-704. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 11-1195. Filed for public inspection July 15, 2011, 9:00 a.m.]

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