eForms Logo

Kentucky Medicaid Prior (Rx) Authorization Form

Kentucky Medicaid prior authorization form is submitted by a physician to secure Medicaid coverage for a non-preferred drug that they have prescribed to a Medicaid patient. The physician uses the form to offer the required explanation for why a medication that is not on the preferred drug list would be better for their patient.
0.0 Stars | 0 Ratings
Downloads: 23

Phone – 1 (800) 807-1232

Fax – 1 (800) 365-8835

Preferred Drug List – List of pre-approved drugs by the State