North Carolina Medicaid’s Adult Safety with Antipsychotic Prescribing (ASAP) Initiative begins Tuesday, March 20, 2012, with a prior authorization policy called “Off Label Antipsychotic Safety Monitoring” for recipients 18 and older.  The first phase of the program will include Medicaid eligible adults receiving atypical (second generation) antipsychotic agents prescribed for an indication that is not approved by the federal Food and Drug Administration (FDA).  Here is the process for obtaining prior authorization:

1. Off label uses such as insomnia, anxiety, and primary treatment of depression will require a fax (866-246-8507) or phone-based (866-246-8505) prior authorization request to be submitted to ACS, a Xerox company who administers medication-related prior authorizations for NC Medicaid.
2. The presence of psychiatric diagnoses such as schizophrenia, bipolar disorder, Tourette’s syndrome, and adjunctive treatment of depression warrant exemption from prior authorization. To authorize an exemption for these specific indications, the prescriber must write in his or her own handwriting “meets PA criteria” on the face of each new or renewal antipsychotic prescription or in the comment block on e-prescriptions. 

For complete information, please refer to the Medicaid website at http://www.ncmedicaidpbm.com/  and the Resources page of http://www.documentforsafety.com/. These sites will be live by the program start date.