Prior Authorization List

The physicians and pharmacists who serve on the Pharmacy & Therapeutics (P&T) Committee are responsible for reviewing all new medications as they come to market. With each agent, they consider whether a medication should be covered under the prescription benefit. In addition, they may recommend quantity limits and prior authorization to ensure appropriate use.

When making a recommendation, the P&T Committee focuses on the medication's overall health benefit as well as the cost. The P&T Committee will consider FDA recommendations, manufacturer package labeling instructions, and published clinical recommendations, such as the Journal of the American Medical Association (JAMA). The P&T has elected to prior authorize the following products:

As of October 31, 2006, Innoviant's general prior authorization form was removed from our Web site in favor of customized forms for specific prior authorization programs. To initiate a prior authorization, please call the number on the back of your ID card. We're available to help 24-hours a day, seven days a week.

A customer service representative can fax a prior authorization form to the prescribing physician. When the physician returns the completed form, a clinical review of the documented information is completed within two business days. The clinical decision is documented in writing to the physician. A copy of the letter provided to the physician is also provided to the member.