Criteria and Forms

As a result of Public Act 097-0689 (pdf), referred to as the Save Medicaid Access and Resources Together (SMART) Act, the department must develop utilization controls, including prior approval, for specialty drugs, oncolytic drugs, drugs for the treatment of HIV or AIDS, immunosuppressant drugs, and biological products in order to maximize savings on these drugs.

Forms

Criteria

Some drugs that previously required special prior approval forms no longer require them. If the drug is not listed above, please submit prior approval requests using the regular prior approval form.

To request prior authorization

By phone: 1-800-252-8942
By fax: 1-217-524-7264


Pharmacy

 

 Need Assistance?