Apple Health Foster Care Antipsychotic Review cancellation notice

HCA Apple Health

PROVIDER ALERT

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.