The Colorado Medicaid program has established an extensive formulary in order to provide pharmaceutical benefits to Medicaid clients.  In order for a provider to prescribe a drug that is not on this established list, the provider must receive an approval on a prior authorization request from the Department. 

 

 

 

 

 

 

 

 

 

 

 

Medical Food Policy

Effective April 1, 2010, medical foods will become a covered pharmacy benefit.  It was determined by the Department that these products are an allowable pharmacy benefit under the prescription vitamin category.  The criteria for authorization are listed in Appendix P with the effective date of April 1, 2010.

 

 

 

 

Global Prior Authorization

The Global Prior Authorization policy became effective on June 1, 2009, to protect the health of Medicaid's most vulnerable clients.  Clients who qualify will be exempt for one year from prior authorization requirements for non-preferred drugs.  They will also be exempt from prior authorization requirements for non-PDL drugs currently requiring prior authorization.  Clients who do not qualify for a Global Prior Authorization may still be eligible for prior authorizations for individual drugs.

 

Department of Health Care Policy and Financing · 1570 Grant Street · Denver, CO 80203-1818 · (303) 866-2993 Phone · (303) 866-4411 Fax