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------ NOTE: THIS ALERT IS CLARIFICATION TO THE ALERT DATED March 18, 2021 ------

TO:   Pharmacy Providers and Pharmacy Association

RE:   Implementation of the Consolidated Prior Authorization Supporting Documentation Form for PA Submissions

Please note: The new “Prior Authorization Supporting Doco” form for all prior authorization (PA) requests via the Forms menu does not apply to Pharmacy Providers. The PA process for drugs is not impacted by this change. Providers should continue to obtain PA from Kepro/Health Information Design following the normal process.

The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 2020 American Medical Association and © 2020 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.