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This alert is an update to provider alerts issued on
May 6, 2016, and June 14, 2016. The
update is necessary because the Health Care Authority (the agency) will not be
making the program changes previously announced.
Antipsychotic
Medications for Foster Care and Adoption Support Clients
What
is changing?
Nothing is changing.
The agency previously announced that all antipsychotic
medications prescribed to children in the Foster Care Medical and Adoption
Support Medical programs would require authorization and review through the
agency’s contracted Second Opinion Network (SON). These
reviews will NOT be required.
What
stays the same?
The agency’s previously existing psychotropic
medication review program remains in place, and applies equally to children in
the Foster Care Medical and Adoption Support Medical programs. Some antipsychotic medications for this
population still require authorization and review through SON when exceeding dosing
limits based on the client’s age.
For more information regarding the SON program,
please see the agency’s Prescription
Drug Program Billing Guide.
For information on specific age and dose limits for
antipsychotic medications, please see the agency’s List
of Drugs with Limitations located on the Pharmacy Information-Medication
Coverage Lists webpage.
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