205.5632 Prior authorization requirements -- Administrative
regulations. (1) Upon initial coverage by the Kentucky Medicaid
program, a new drug shall be exempt from prior authorization
unless: (a) There has been a review of the drug and
recommendation regarding prior authorization by the Pharmacy and
Therapeutics Advisory Committee as provided under KRS 205.564 and a
final determination regarding prior authorization by the secretary
of the Cabinet for Health and Family Services; or (b) The
drug is in a specific class of drugs for which the Pharmacy and
Therapeutics Advisory Committee has recommended, and the secretary
of health and family services has determined, that all new drugs
shall require prior authorization upon initial availability, in
which case the drug shall require prior authorization and shall be
scheduled for review by the Pharmacy and Therapeutics Advisory
Committee within seventy-five (75) days. (2) The Cabinet for Health
and Family Services shall promulgate an administrative regulation
in accordance with KRS Chapter 13A that describes the process by
which drugs under this section shall be determined to require prior
authorization. Effective: June 20, 2005 History:
Amended 2005 Ky. Acts ch. 99, sec. 236, effective June 20, 2005. --
Amended 2002 Ky. Acts ch. 7, sec. 3, effective February 21, 2002.
-- Amended 2000 Ky. Acts ch. 521, sec. 26, effective July 14, 2000.
-- Created 1998 Ky. Acts ch. 561, sec. 2, effective July 15, 1998.
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