NYRx, the Medicaid Pharmacy Program

somatropin (Serostim®)

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somatropin (Serostim®)

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

Prior Authorization Fax Line: 1-800-268-2990

Prior authorization for somatropin (Serostim®) is required to assure medical necessity and to deter the potential of, or history of, drug diversion or illegal utilization. Only prescribers, not their authorized agents, can initiate the prior authorization process for Serostim®. An authorized agent is an employee of the prescribing practitioner and has access to the patient's medical records (i.e. nurse, medical assistant).

Prior authorization requirements:

Please be prepared to respond to a series of questions that identify the prescriber, the patient and the reason for prescribing this drug.
Please be prepared to fax clinical documentation upon request.
The CDRP somatropin (Serostim®) Worksheet provides step-by-step assistance in completing the prior authorization process.