- Form can be faxed to: 1 (800) 424-5881
- Phone number: 1 (800) 424-5725
- Preferred Drug List
Colorado Medicaid Prior (Rx) Authorization Form
A Colorado Medicaid prior authorization form is used by a medical professional to prescribe a drug not on the preferred drug list to a Medicaid patient. In order for a patient to receive a non-preferred drug, the physician must submit this form and their justification for prescribing the medication to the Department of Health Care Policy & Financing.
Updated November 11, 2024
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