Pharmacy Prior Authorization [44 Pa.B. 7143]
[Saturday, November 8, 2014]The Department of Public Welfare (Department) announces it will add compounded drugs, Oral Anti-Allergens, Mozobil (plerixafor), Ranexa (ranolazine), Rilutek (riluzole), Soliris (eculizumab) and Xenazine (tetrabenazine) 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 compounded drugs, Oral Anti-Allergens, Mozobil (plerixafor), Ranexa (ranolazine), Rilutek (riluzole), Soliris (eculizumab) and Xenazine (tetra-benazine). These prior authorization requirements apply to prescriptions dispensed on or after December 9, 2014.
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
It is anticipated that this change will result in minimal savings in the MA Outpatient appropriation.
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 AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
BEVERLY MACKERETH,
SecretaryFiscal Note: 14-NOT-913. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 14-2334. Filed for public inspection November 7, 2014, 9:00 a.m.]
