Section 205.5632 - Prior authorization requirements - Administrative regulations(1) Upon initial coverage by the Kentucky Medicaid program, a new drug shall be exempt from prior authorization unless: (a) There has been a review of the drug and recommendation regarding prior authorization by the Pharmacy and Therapeutics Advisory Committee as provided under KRS 205.564 and a final determination regarding prior authorization by the secretary of the Cabinet for Health and Family Services; or(b) The drug is in a specific class of drugs for which the Pharmacy and Therapeutics Advisory Committee has recommended, and the secretary of health and family services has determined, that all new drugs shall require prior authorization upon initial availability, in which case the drug shall require prior authorization and shall be scheduled for review by the Pharmacy and Therapeutics Advisory Committee within seventy-five (75) days.(2) The Cabinet for Health and Family Services shall promulgate an administrative regulation in accordance with KRS Chapter 13A that describes the process by which drugs under this section shall be determined to require prior authorization.Effective:6/20/2005
Amended 2005, Ky. Acts ch. 99, sec. 236, effective6/20/2005. -- Amended 2002, Ky. Acts ch. 7, sec. 3, effective 2/21/2002. -- Amended 2000, Ky. Acts ch. 521, sec. 26, effective 7/14/2000. -- Created 1998, Ky. Acts ch. 561, sec. 2, effective 7/15/1998.