| A publication of Pine Tree Legal Assistance |
Summer 2005
DSS Preferred Drug Lists for Prescription Drugs
The following article appeared in the May 2005 edition of CABN Fever. Click on the CABN Fever linkOn June 1, 2005 the Department of Social Services will begin requiring doctors or providers to seek "prior authorization" - authorization that must be obtained before prescribing drugs for elderly and disabled Medicaid and SAGA recipients who need Proton Pump Inhibitors which are not on DSS's preferred drug list. Only Prevacid and Protonix will be available without prior authorization.
On June 8, 2005, preferred drug lists will become effective for several other categories of drugs: Ace Inhibitors, Minimally Sedating Antihistamines, Bone Resorption Inhibitors, Calcium Channel Blockers, Intranasal Corticosteroids and Non- Steroidal Anti-Inflammatory Drugs. A complete listing of all drugs on the preferred drug list in these categories is available by clicking here
If your prescription is rejected at the pharmacy, here's what you should do:
- Ask the pharmacist why the prescription is not being filled. If the pharmacist says that the state or HMO won't pay for the drug or the drug is not covered by insurance, ask the pharmacist for a printout from the computer screen that shows the reason for the denial of payment for the drug. (Note: The reason may be something like "needs prior approval," "claim rejected," "requires step therapy," or "not covered.") Call Statewide Legal Services (1-800-453-3320) for help.