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Prior Authorization (PA)

  • Prior Authorization Archive - 2009 | 2010 | 2011 | 2012 | 2013 
  • Covered Drugs for Dual Eligible Individuals

    • Therapeutic Categories:

    • Antibiotics - Cephaloporins, Ketoconazole Oral Tablets, Skin and Soft Tissue, Special Formulations
    • Cardiovascular - Antihypertensives, Antiplatelet, Antihyperlipidemics, Clonidine Products, Revatio
    • Central Nervous System/Behavioral Health - ADHD & Narcolepsy, Alzheimer's, Antidepressants, Anti-Migraine, Anxiolytic/Hypnotic, Atypical Antipsychotics, Fibromyalgia, Multiple Sclerosis, Narcotic Analgesics, Parkinson's, Restless Leg Syndrome, Requip XL/Mirapex ER, Smoking Cessation, Substance Abuse Treatment
    • Diabetes/Endocrine - Diabetic Medications, Erythropoietin Stimulating Agents, Growth Hormone, Makena®, Testosterone
    • Gastro-Intestinal - Amitiza, Anti-emetic, Anti-Ulcer
    • Genitourinary System - Benign Prostatic Hyperplasia (BPH), Bladder Control Drugs
    • Hepatitis C - Harvoni, Incivek, Olysio, Sovaldi, Victrelis
    • Metabolic Disorders- Procysbi - Ravicti
    • Ocular/Otic - Ocular Allergy, Opthalmic Anti-Infective/Steroid, Ophthalmic Corticosteroid, Ophthalmic NSAIDs, Ophthalmic Glaucoma, Otic Anti-Infective
    • Respiratory - Asthma & COPD Inhalation Medications, Antihistamines, Leukotriene Modifiers, Nasal Allergy Sprays, Synagis, Tobi/Pulmozyme, Xolair
    • Skeletal System - Amrix & Fexmid, Bisphosonates, Forteo, Gout, NSAIDs, Skeletal Muscle Relaxants, Soma
    • Targeted Immunomodulator Agents - Botulinum toxins, Hematopoetic, Immunomodulating, Replacement Therapy, Respiratory, Skeletal
    • Topical - Antifungal, Elidel/Protopic, Lidoderm Patch, Pediculicides, Topical Antibiotic Medications, Topical Corticosteroids
    Last Modified on Dec 14, 2022
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    Oklahoma Health Care Authority

    4345 N Lincoln Blvd

    Oklahoma City, OK 73105

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    The Oklahoma Health Care Authority collects the personally identifiable data submitted and received in regard to applications for services, renewals, appeals, provision of health care and processing of claims. This data is treated as confidential and is stored securely in accordance with applicable law and regulations. OHCA may share this personally identifiable data with its authorized business associates, government agencies with jurisdiction over the OHCA, or as otherwise required or permitted by applicable law.