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Prior authorization for Rx infant formula suspended until Aug 18
June 7, 2022

This article is for primary care providers caring for our members

Due to the current supply chain issues affecting infant formula nationwide, the Division of Insurance has instructed insurers to relax prior authorization requirements for prescription infant formula for 90 days. For this reason, we will suspend the prior authorization requirements noted in Pharmacy Medical Policy 304, Special Foods, effective immediately until August 18, 2022. Members must continue to meet medical necessity requirements for coverage of infant formula. A valid prescription from a licensed health care provider is required to receive coverage.

Unless otherwise instructed by the Division of Insurance, we will resume the prior authorization requirements of Pharmacy Medical Policy 304 for dates of service on and after August 19, 2022.