Prior authorization is required for certain drugs prescribed to North Carolina Medicaid and Health Choice recipients. This website should help prescribers and pharmacists understand the process required to obtain prior authorization.
During State Fiscal year 2012, the Medicaid program spent a net amount after rebates of $563 million on outpatient prescription drugs for 1.58 million recipients. The pharmacy benefit continues to be one of the most costly components of the Medicaid budget.
The State must continue to ensure that the pharmacy program operates as efficiently as possible. Therefore, the prior authorization program continues to play an important role in controlling spiraling health care costs.
Xerox State Healthcare, LLC, administers
the pharmacy program's prior authorization program. Contact Xerox State Healthcare, LLC, toll free
at 866-246-8505 (telephone) or 866-246-8507 (fax) for prior authorization