Page 1 of 1 205.5632 Prior authorization requirements -- Administrative regulations. (1) Upon initial coverage by the Kentucky Medicaid program, a new drug shall be exempt from prior authorization unless: <br>(a) There has been a review of the drug and recommendation regarding prior authorization by the Pharmacy and Therapeutics Advisory Committee as <br>provided under KRS 205.564 and a final determination regarding prior <br>authorization by the secretary of the Cabinet for Health and Family Services; <br>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 <br>health and family services has determined, that all new drugs shall require <br>prior authorization upon initial availability, in which case the drug shall <br>require prior authorization and shall be scheduled for review by the Pharmacy <br>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 <br>which drugs under this section shall be determined to require prior authorization. Effective: June 20, 2005 <br>History: Amended 2005 Ky. Acts ch. 99, sec. 236, effective June 20, 2005. -- Amended 2002 Ky. Acts ch. 7, sec. 3, effective February 21, 2002. -- Amended 2000 Ky. Acts <br>ch. 521, sec. 26, effective July 14, 2000. -- Created 1998 Ky. Acts ch. 561, sec. 2, <br>effective July 15, 1998.
Page 1 of 1 205.5632 Prior authorization requirements -- Administrative regulations. (1) Upon initial coverage by the Kentucky Medicaid program, a new drug shall be exempt from prior authorization unless: <br>(a) There has been a review of the drug and recommendation regarding prior authorization by the Pharmacy and Therapeutics Advisory Committee as <br>provided under KRS 205.564 and a final determination regarding prior <br>authorization by the secretary of the Cabinet for Health and Family Services; <br>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 <br>health and family services has determined, that all new drugs shall require <br>prior authorization upon initial availability, in which case the drug shall <br>require prior authorization and shall be scheduled for review by the Pharmacy <br>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 <br>which drugs under this section shall be determined to require prior authorization. Effective: June 20, 2005 <br>History: Amended 2005 Ky. Acts ch. 99, sec. 236, effective June 20, 2005. -- Amended 2002 Ky. Acts ch. 7, sec. 3, effective February 21, 2002. -- Amended 2000 Ky. Acts <br>ch. 521, sec. 26, effective July 14, 2000. -- Created 1998 Ky. Acts ch. 561, sec. 2, <br>effective July 15, 1998.
Page 1 of 1 205.5632 Prior authorization requirements -- Administrative regulations. (1) Upon initial coverage by the Kentucky Medicaid program, a new drug shall be exempt from prior authorization unless: <br>(a) There has been a review of the drug and recommendation regarding prior authorization by the Pharmacy and Therapeutics Advisory Committee as <br>provided under KRS 205.564 and a final determination regarding prior <br>authorization by the secretary of the Cabinet for Health and Family Services; <br>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 <br>health and family services has determined, that all new drugs shall require <br>prior authorization upon initial availability, in which case the drug shall <br>require prior authorization and shall be scheduled for review by the Pharmacy <br>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 <br>which drugs under this section shall be determined to require prior authorization. Effective: June 20, 2005 <br>History: Amended 2005 Ky. Acts ch. 99, sec. 236, effective June 20, 2005. -- Amended 2002 Ky. Acts ch. 7, sec. 3, effective February 21, 2002. -- Amended 2000 Ky. Acts <br>ch. 521, sec. 26, effective July 14, 2000. -- Created 1998 Ky. Acts ch. 561, sec. 2, <br>effective July 15, 1998.
