Antipsychotic Medication Access

Overview

 

The NC Medicaid Outpatient Pharmacy Program implemented changes to important programs affecting antipsychotic prescribing on Friday, June 5, 2015. These programs are Antipsychotics – Keeping It Documented for Safety (A+KIDS) and Adult Safety with Antipsychotic Prescribing (ASAP).

 

What are the Programs?

 

A+KIDS – The program encourages the use of appropriate baseline and follow-up monitoring parameters to facilitate the safe and effective use of antipsychotics in Medicaid and Health Choice beneficiaries under the age of 18. Providers will once again be able to document information regarding the efficacy of therapy, side effects, and metabolic monitoring parameters (height/weight/BMI percentile, lipid panel, and blood glucose). Once the information is submitted to the NCTracks web-based portal or phoned in successfully, the medication is authorized for 6 months.

 

ASAP – The program targets off-label prescribing of antipsychotic agents and will include Medicaid eligible adults (age >=18) on atypical (second generation) antipsychotic agents prescribed for an indication that is not approved by the federal Food and Drug Administration. To authorize the prior authorization for approved indications, the prescriber must write in his or her own handwriting “meets PA criteria” on the face of each new or renewal antipsychotic prescription or in the comment block on e-prescriptions. The authorization period is equivalent to the length of the prescription.

 

Providers will be required to fill these prior authorizations through the NCTracks Provider Portal or by calling CSC at 1-866-246-8505. Faxed forms will not be accepted.

 

Below are documents to help you through the process:

 

A+KIDS Program

ASAP Program

Antipsychotic PDL Changes Effective 6/5/2015