Preferred Drug List – List of pre-approved drugs by the State
Georgia Medicaid Prior (Rx) Authorization Form
A Georgia Medicaid prior authorization form is used by a medical professional to request Medicaid coverage of a non-preferred drug on behalf of a patient. In addition to this form, any supporting medical documentation and notes that help to justify the use of a non-preferred drug to treat a patient must be included with the physician's request.
Updated November 12, 2024
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