Attention: Pharmacists and Prescribers A+KIDS and ASAP Programs to be Re-instated June 5, 2015

Effective June 5, 2015, the N.C. Division of Medical Assistance (DMA) will re-instate the Off-Label Antipsychotic Safety Monitoring in Beneficiaries Through Age 17 (A+KIDS) and Off Label Antipsychotic Safety (ASAP-adults) programs. Providers will be required to fill out an A+KIDS or ASAP prior authorization (PA) for any preferred or non-preferred antipsychotic medication for children 17 and younger.

Providers will be required to fill this PA through the NCTracks Provider Portal or by calling CSC at 1-866-246-8505. THERE WILL BE NO FAX FORMS.
 
For more information, refer to Clinical Coverage Policy A6, Off Label Antipsychotic Safety Clinical Coverage Policy No: 9D Monitoring in Beneficiaries Through Age 17,located on the DMA website at www.ncdhhs.gov/dma/mp/.

 

Pharmacists: Pharmacists can use an “11” in the Submission Clarification Field to override both types of PA requirements to ensure patients obtains their medications. This can only be used two times, so inform the prescriber the need for PA. In addition, “Meets PA Criteria” may be written on adult antipsychotic prescriptions, and prescribers may use a “1” in the PA Type Code field or a “2” in the Submission Clarification field to override the PA edits. All non-preferred medication requests will require the non-preferred ASAP or A+KIDS PA to be processed. There is no override. Use the 72-hour override, (a “3” in the Level of Service field), to ensure no gaps in therapy.