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Age prior authorization requirement for tricyclic antidepressants to take effect August 17

Age prior authorization requirement for tricyclic antidepressants to take effect August 17

Beginning Aug. 17, 2020, the Mississippi Division of Medicaid (DOM) will require prior authorization of (PA) tricyclic antidepressants (TCA) prescribed for patients under 25 years of age for all Medicaid beneficiaries. Following recommendations by the Drug Utilization Review Board (DUR), the PA requirement is based on safety risks associated with TCA use in children, adolescents and young adults.

The Food and Drug Administration has warned that antidepressants increase the risk of suicidal thoughts and behavior in children, adolescents and young adults diagnosed with psychiatric disorders.

Prescribers of TCAs for patients under 25 years of age will need to attest that the medical necessity outweighs the risks for these medications. To ensure prompt prescription processing prescribers should notate the diagnosis on the prescription, and pharmacists should submit the diagnosis code on the prescription claim.

Providers may submit PA requests in advance of the Aug. 17 effective date. The Universal Prior Authorization form can be found at: https://medicaid.ms.gov/providers/pharmacy/pharmacy-prior-authorization/