Drug Prior Approval Information

Some prescriptions and over-the-counter medicines require prior authorization for Medicaid reimbursement. Depending upon the drug, either the prescribing physician or the dispensing pharmacist may submit the request.

• NCPDP D.0 electronic format P4 Prior Approval Request Only Transaction (pdf)

• Fax to the Drug Prior Approval Hotline at 217-524-7264 or 217-524-0404

• Call the Drug Prior Approval hotline at 1-800-252-8942

• Directly data enter into the Drug Prior Approval/Refill Too Soon Entry System through the department's Medical Electronic Data Interchange (MEDI) System

• NCPDP D.0 electronic format P4 Prior Approval Request Only Transaction (pdf)

• Call the department�s Prior Approval hotline at 1-800-252-8942.

Depending upon the drug, either the prescribing physician or the dispensing pharmacist may submit the request. Certain drugs require specific forms.

• Drug Prior Approval request form (pdf)
• Refill Too Soon Prior Approval request form (pdf)
• Drugs requiring specific forms