NYRx, the Medicaid Pharmacy Program

Prior Authorization Call Line: 1-877-309-9493

Prior authorization of Growth Hormones for enrollees 18 years of age or older has been implemented to address appropriate utilization consistent with approved indications including factors associated with long-term efficacy, public health and potential for overuse or misuse. Requests for prior authorization of growth hormones for enrollees 18 years of age or older can be initiated by either prescribers or their authorized agents. An authorized agent is an employee of the prescribing practitioner and has access to the patient's medical records (i.e. nurse, medical assistant).

If you are requesting prior authorization of Human Growth Hormone for HIV wasting in adults (Serostim), please go to https://newyork.fhsc.com/providers/CDRP_serostim.asp.

The following is general information about Growth Hormones prior authorization requirements:

• Please be prepared to respond to a series of questions that identify the prescriber, the patient and the reason for prescribing a drug in this class for enrollees 18 years of age or older.
• Five refills for Growth Hormone prescriptions are allowed.
• If you are prescribing Growth Hormones for enrollees under the age of 18, please refer to the Preferred Drug Program web page and review the list of preferred and non-preferred drugs.
• The CDRP Growth Hormone Worksheet provides step-by-step assistance in completing the prior authorization process.