What is the Prior Plan Approval process?
All requests for medications that require Prior Authorization or that are not listed on CHA Health’s Preferred Drug List and/or Abbreviated Prescription Drug List should be sent to CHA Health’s Pharmacy Benefits Manager, MedImpact. Your doctor can make this request from his/her office. Physicians should call the Pharmacy Help Desk at 1-800-788-2949 or fax a Medication Request Form (MRF) to MedImpact at 1-858-578-9732. MedImpact reviews the request against criteria for the specific drug and your physician receives a response. Many of these established criteria are based upon generally accepted clinical practice guidelines within the medical community. These MRFs are then forwarded to CHA Health for another review and based on CHA Health’s review by the Pharmacy Department, your doctor is notified again. Your physician can refer to the CHA Health Provider Manual under the Pharmacy Section for further details in this process.
