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Washington D.C. Medicaid Prior Authorization Form

A Washington D.C. Medicaid prior authorization form can be used by a medical provider to request Medicaid coverage for a drug that is not on the preferred drug list (PDL). In order for the request to be valid, the prescriber must present their medical justification for not prescribing a preferred drug and submit any necessary supporting documents.
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Preferred Drug List – list of pre-approved drugs in the District of Columbia