Prior authorization process
Maricopa County Medicaid Pharmacy Program
Behavioral health medical practitioners may request prior authorization by fax (or by phone for urgent requests), using the following process:
- Review the formulary and the prior authorization criteria.
- Complete one of the prior authorization request forms below in the Prior Authorization Request Form section.
- Fax the completed prior authorization request form to (866) 498-0628.
- For urgent requests, call the Pharmacy Help Desk at (800) 790-1631.
- You will be notified of the initial decision as quickly as possible and no later than 24 business hours.
- If the request is not approved, the consumer will receive a notice of action on how to appeal the decision if needed.
Prior authorization criteria
Effective Jan. 1, 2014, Magellan will utilize the state-wide ADHS/DBHS prior authorization criteria for both Title XIX/XXI and Non-Title XIX SMI recipients. To access the new new DBHS State-Wide Prior Authorization Criteria effective Jan. 1, 2014, please visit http://www.azdhs.gov/bhs/drug-list-prior-authorization-guidelines.php
- General Prior Authorization Request Form (2013)
- Fax Authorization Request Form for Pharmacy Lock-in (10-2012)
- High Cumulative-Dose Benzodiazepines
- Abilify Maintena Prior Authorization (11-2013)
- Pregnancy and Mood Stabilizers
- Antipsychotic Use in Pregnancy
- Best Practice ADHD Monitoring Guidelines
- Best Practice Antidepressant Monitoring Guidelines
- Best Practice Antipsychotics Monitoring Guidelines
- Best Practice Mood Stabilizers Monitoring Guidelines
- Prescribing guidelines for antidepressants (108K)
- Prescribing guidelines for atypical antipsychotics (123K)
- Prescribing guidelines for stimulants for ADHD (104K)
- Adjunctive Use Atypical Antipsychotics (4-19-12)
- Clozapine program processes (337KB)
- Magellan Anticholinergic Risk Scale
- FAQ Citalopram, Escitalopram and QTc prolongation for behavioral health medical practitioner's
- Patient's Handout for Citalopram/Escitalopram and the FDA Warning
Quarterly Clinical Updates
- Quarterly Clinical Update Winter 2014
- Quarterly Clinical Update Fall 2013
- Quarterly Clinical Update Summer 2013
- Quarterly Clinical Update Spring 2013
- Quarterly Clinical Update Winter 2013
- Quarterly Clinical Update Fall 2012