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- Antidepressant Medication
- Baby Partners
- CAHPS Resources
- Care Guidelines
- Developmental Screenings and Surveillance
- Diabetes Prevention Programs
- Disease and Medication Management
- EPSDT / Bright Futures
- ICD-10 Coding and Risk Adjustment
- Lead Screening
- Medication Management and Adherence
- Oral Health Resources
- Quality and Population Health
- Patient Management
- Patient Safety Reporting
- Member Rewards
- Smoking Cessation
- TiPS: Telephonic Psychiatric Consultation Service Program
Providers
Drug-Specific Prior Authorizations Medicaid and CHIP
Prior Authorization Requirements for Medicaid and CHIP
Drugs listed on this page require prior authorization from Medicaid and CHIP.
If you wish to prescribe a drug on this list, click on its name to download the associated prior authorization form in PDF format. Using the appropriate form will help to ensure that we have the information necessary to make a decision about your request.
Please note that there are different prior authorization forms for Medicare and Individual and Family Plans. To access those forms, visit the Medicare and IFP pages: