...Urine Drug Screening Prior Authorization Form – Submit this form when requesting prior authorization for urine drug screenings Submit the SUD 1115 Waiver Universal PA Form to request prior authorization...

...Form Submit this form to request continuation of care for orthodontic services. Orthodontic Evaluation and Predetermination Form Submit this form to request prior authorization for orthodontic services. Orthodontic Form for...

...die from sudden infant death syndrome, also known as SIDS. It expensive. Smoking a pack of cigarettes a day costs on average more than $3,500 a year. Vaping or using...

...get support. Feeding Baby Choosing to breastfeed, formula feed, or a combination of both is a hard decision for many new parents. Breastfeeding We want you to have the tools...

...at 1-833-230-2005 (TDD/TTY: 711) to tell us. We can also mail you a form to send back. Fill out the Grievances and Appeals form. Mail us a letter. Mail the...

...Drug Lists Georgia Medicaid and PeachCare for Kids® Planning for Healthy Babies® (P4HB) Family Planning P4HB Inter-Pregnancy Care (IPC) OTC PDL Many Georgia Medicaid members pay a small part of...

...can use pay stubs to do this. Pay Stubs must be less than 90 days from the renewal deadline. For more information about P4HB® renewals, visit the P4HB website or...

...on the left side (bottom) of the page to find a pharmacy near you. Covered Prescriptions CareSource uses a Prescription Drug Formulary (or just Formulary). Your Formulary is a list...

...Us page. If you have questions, CareSource PASSE is here to help you find answers. Visit the Contact Us page to help us direct you to the correct area. Tools...

...menu to launch the SUPDL. Prior authorization (PA) criteria links can be found with the associated Drug Class within this document. Note: PA Forms are on the Forms page under...