10- 144 C.M.R. ch. 272, § VII-J
Current through 2024-51, December 18, 2024
For those children requiring medications to treat their medically eligible condition and prescribed by the treating subspecialist or pediatric specialist, the C.C.S./C.S.H.N. Program will pre-authorize payment for:
medications requiring a written prescription unless otherwise stated; and/or long term medications requiring a written prescription that are included in the subspecialist's plan of care whose refills can be renewed and monitored by the child's primary care physician. Any change in prescription requires the verification of the treating subspecialist.NOTE:All pharmaceuticals require prior authorization, whether verbally or in writing.
NON-COVERED PHARMACEUTICAL SERVICES: over-the-counter medications unless otherwise stated, and "less than effective drugs" as defined by the Food and Drug Administration and on file with the Bureau of Medical Services, the State Medicaid program.
10- 144 C.M.R. ch. 272, § VII-J