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Medication Prior Authorization Program

Per federal law , state Medicaid programs may require, as a condition of coverage or payment for a covered outpatient drug, the prior approval of the drug before it is dispensed for any medically accepted indication.

The 2003 Legislative Assembly passed House Bill 1430 . This restructured the existing Drug Use Review (DUR) Board and required the Board to advise the Department of Human Services in developing a Prior Authorization (PA) process to help assure that beneficiaries receive appropriate medications in the most cost-effective manner, thus conserving state expenditures for drugs whenever possible.

Questions? Contact Brendan Joyce, PharmD, Administrator, Pharmacy Services at bjoyce@nd.gov .


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