Many medications require Prior Authorization (PA) before being dispensed to a Medicaid member. Under contract with the Montana Department of Public Health and Human Services (DPHHS), our expert team of clinical pharmacists and pharmacy technicians supports the Montana Healthcare Programs prescription program, the Healthy Montana Kids prescription program and the Home Infusion Therapy program as policy advisors. As a call center, we collaborate with health care professionals, including providers’ offices and pharmacies, to conduct clinical medication reviews. The primary focus is to determine the clinical appropriateness of a medication while making sure medications are in compliance with the Montana Healthcare Program’s Preferred Drug List and set criteria.
For any questions or to request authorization, the Drug PA Unit can be reached at 1-800-395-7961.