161![Important Announcement Regarding Behavioral Health Prior Authorization As of October 1, 2014, MDwise Hoosier Healthwise (HHW)/Healthy Indiana Plan (HIP) will no longer require Prior Authorization for in-network providers Important Announcement Regarding Behavioral Health Prior Authorization As of October 1, 2014, MDwise Hoosier Healthwise (HHW)/Healthy Indiana Plan (HIP) will no longer require Prior Authorization for in-network providers](https://www.pdfsearch.io/img/f1b8f8b39e9cb494240f85cbd4a9089a.jpg) | Add to Reading ListSource URL: www.mdwise.org- Date: 2014-10-02 19:41:57
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162![Medicare Prior Authorization of Power Mobility Devices Demonstration Status Update (Posted[removed]The Medicare Prior Authorization of Power Mobility Devices (PMDs) Demonstration began on September 1, 2012 in Californ Medicare Prior Authorization of Power Mobility Devices Demonstration Status Update (Posted[removed]The Medicare Prior Authorization of Power Mobility Devices (PMDs) Demonstration began on September 1, 2012 in Californ](https://www.pdfsearch.io/img/f4a2e78ccce5255061c4aa633e73e8e3.jpg) | Add to Reading ListSource URL: www.cms.govLanguage: English - Date: 2014-09-18 18:12:42
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163![United States Department of the Interior DI-4002: Rules of Behavior for Computer Network Users As a DOI computer network user, you must understand and agree to these rules of behavior prior to being granted access to the United States Department of the Interior DI-4002: Rules of Behavior for Computer Network Users As a DOI computer network user, you must understand and agree to these rules of behavior prior to being granted access to the](https://www.pdfsearch.io/img/04da8412446821e997d2e40fad21b812.jpg) | Add to Reading ListSource URL: www.doi.govLanguage: English - Date: 2014-11-13 08:23:07
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164![[removed]Mississippi Division of Medicaid Synagis® Prior Authorization Criteria* Beneficiaries must meet at least one of the bullet point criteria for age at beginning of the RSV season. Age ≤ 1 year at start of RSV se [removed]Mississippi Division of Medicaid Synagis® Prior Authorization Criteria* Beneficiaries must meet at least one of the bullet point criteria for age at beginning of the RSV season. Age ≤ 1 year at start of RSV se](https://www.pdfsearch.io/img/6f9b375d74d2a5c85c5074df1ac34a91.jpg) | Add to Reading ListSource URL: www.medicaid.ms.govLanguage: English - Date: 2014-12-16 19:38:03
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165![Antipsychotic Drug Monitoring Prior Authorization Criteria for Psychotropic Drugs submitted by Nevada During FFY2011, Nevada Medicaid adopted prior authorization criteria for psychotropic medications for children and ado Antipsychotic Drug Monitoring Prior Authorization Criteria for Psychotropic Drugs submitted by Nevada During FFY2011, Nevada Medicaid adopted prior authorization criteria for psychotropic medications for children and ado](https://www.pdfsearch.io/img/db488e09cd90dbcd98d3e8482a727787.jpg) | Add to Reading ListSource URL: medicaid.govLanguage: English - Date: 2014-12-04 14:15:59
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166![FORM INSTRUCTIONS DHS 1144B (Rev[removed]Request for Medical Authorization of Home Infusion or Medication Prior Authorization (PA) PURPOSE: Fee For Service program request for medical authorization of home infusion or me FORM INSTRUCTIONS DHS 1144B (Rev[removed]Request for Medical Authorization of Home Infusion or Medication Prior Authorization (PA) PURPOSE: Fee For Service program request for medical authorization of home infusion or me](https://www.pdfsearch.io/img/3d074f73b8c4b0633d47b30d42f48ecd.jpg) | Add to Reading ListSource URL: med-quest.usLanguage: English - Date: 2012-01-27 15:57:25
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167![New DME and O&P Prior Authorization List Effective[removed]Please note: Effective[removed], New Hampshire Healthy Families will move to a standardized list of Durable Medical Equipment and Orthotic and Prosthetic items re New DME and O&P Prior Authorization List Effective[removed]Please note: Effective[removed], New Hampshire Healthy Families will move to a standardized list of Durable Medical Equipment and Orthotic and Prosthetic items re](https://www.pdfsearch.io/img/11ff75ac9749e475a7a46c744119cf49.jpg) | Add to Reading ListSource URL: www.nhhealthyfamilies.comLanguage: English - Date: 2014-10-07 13:54:46
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168![Passport Health Plan Prior Authorization Fuzeon® Procedure and Required Information, HIV RNA Tracking, and Medication History (Documenting Failure to Oral Anti-Retroviral Therapy) Passport Health Plan Prior Authorization Fuzeon® Procedure and Required Information, HIV RNA Tracking, and Medication History (Documenting Failure to Oral Anti-Retroviral Therapy)](https://www.pdfsearch.io/img/702d859ea10a9ff53c5570e7234f4fb7.jpg) | Add to Reading ListSource URL: www.passporthealthplan.comLanguage: English - Date: 2014-03-31 16:23:21
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169![Passport Health Plan Medication Prior Authorization Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health information and subject to all privacy and securi Passport Health Plan Medication Prior Authorization Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health information and subject to all privacy and securi](https://www.pdfsearch.io/img/d40d8df69ac38ae9bed7f2cc25d1c577.jpg) | Add to Reading ListSource URL: www.passporthealthplan.comLanguage: English - Date: 2014-03-31 16:23:51
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170![Specialty Drug List Blue Cross of Idaho regards the following list of medications as specialty drugs. Most specialty drugs require prior authorization from Blue Cross of Idaho for medical necessity. If covered, Blue Cros Specialty Drug List Blue Cross of Idaho regards the following list of medications as specialty drugs. Most specialty drugs require prior authorization from Blue Cross of Idaho for medical necessity. If covered, Blue Cros](https://www.pdfsearch.io/img/3aebbe9d5f8f14e54a6950e725aa17e0.jpg) | Add to Reading ListSource URL: members.bcidaho.comLanguage: English - Date: 2014-12-18 11:40:48
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