Pharmacy Prior Authorizations for Medicaid and CHIP

Certain services, items and prescriptions for some injectable or infusion drugs must be pre-approved. 

Prior Authorization Drug Lists

Below are detailed lists of medical drugs that require prior authorization and the area responsible for the prior authorization review.

Frequently Asked Questions

Jefferson Health Plans requires prior authorizations for select services performed in an outpatient setting, including those performed in the office, short procedure units, ambulatory surgery centers, clinics and hospital outpatient departments.

Click here to view administrative, authorization and maternity care forms. You can also place supply requests from this page.

More information about denials can be found in the provider manual.