Prescription drugs are covered when ordered by an in-network CCP provider. Some medications may require prior authorization or have limitations based upon the member’s age, drug dosage and/or maximum quantity limits. We encourage you to utilize generics whenever possible. We request that you proactively educate your patients as you see them and that you participate with us in educational initiatives.
CCP contracts with Magellan Pharmacy Solutions to process all pharmacy claims for prescribed drugs. Prior authorization is required for medications listed as PA on the PDL, and those not listed on the PDL.
When requesting prior authorization, please use the Community Care Plan - Florida Healthy Kids Pharmacy Prior Authorization (PA) Request Form and include the Member ID number, complete diagnosis, medical history and current medications readily available. Upon receipt of all necessary information, Magellan will respond by fax or phone within 24 hours except during weekends and holidays. If the request is approved, the information in the on-line pharmacy claims processing system will be changed to allow the specific member to receive this specific drug. If the request is denied, information regarding the denial will be provided to the prescribing provider.
Prior Authorization Phone:
Prior Authorization Fax:
Mailing Address:
In accordance with s. 409.912(51) F.S. effective September 1, 2011, prescriptions for psychotropic medication prescribed for a child under the age of thirteen must be accompanied by the express written and informed consent of the member’s parent or legal guardian. Psychotropic (Psychotherapeutic) medications include antipsychotics, antidepressants, anti-anxiety medications, and mood stabilizers. Anticonvulsants and ADHD medications (stimulants and non-stimulants) are not included at this time. The prescriber must document the consent in the child’s medical record and provide the pharmacy with a signed attestation of this documentation with the prescription.
The prescriber must ensure completion of the Medicaid “Informed Consent for Psychotherapeutic Medication” attestation form, the Department of Children and Families CF1630 form and provide the court order for the medication, or an attestation form that includes all elements on the Medicaid attestation form. Every new prescription will require a new informed consent form.
The Medicaid attestation form can be accessed at
https://ahca.myflorida.com/Medicaid/Prescribed_Drug/med_resource.shtml
The DCF CF1630 form can be accessed at
https://eds.myflfamilies.com/DCFFormsInternet/Search/DCFFormSearch.aspx
To locate a pharmacy for a Community Care Plan – Florida Healthy Kids enrollee, please click here.