CHANGE TO PRIOR AUTHORIZATIONS PROCESS – SPECIALTY PHARMACY

As of August 5, 2019, MetroPlus will internally review prior authorizations for specialty medications only. Previously these requests were reviewed by CVS Caremark on behalf of MetroPlus. Non-specialty medications will still be reviewed by CVS Caremark.

There are a few changes to note.

  • The new fax number to send prior authorization requests for Specialty medications will be: 1-844-807-8455.
  • The new mailing address to send prior authorization requests will be: 50 Water Street, 7th Floor
    New York N.Y. 10004
  • The new phone number to request prior authorizations or additional information for specialty medications: 1-800-303-9626
  • There will be no changes in how you request prior authorization through E-PA.

All written communication in reference to specialty medication prior authorizations including faxes, letters and rejection messages at the Pharmacy will contain the correct information.

For a list of medications that MetroPlus covers please visit our Pharmacy page.

last updated: July 31, 2019

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