PA Criteria

Effective November 13, 2017, all pharmacy related calls (to include prior authorizations) will be handled by OptumRx. Member and eligibility questions will continue to be answered by South Dakota Medicaid.  The contact information for OptumRx is listed below:

  • Help Desk:                                                     (855) 401-4262                       Optum Rx
  • FFS Pharmacy Prior Authorization support:     (855) 401-4262                       Optum Rx
  • FFS Pharmacy Prior Auth. Fax Number:           (800) 527-0531                       Optum Rx 

South Dakota Department of SocialServices now requires Prior Authorization for the following drugs. All criteria algorithims are in .pdf format. In order to view and print these documents correctly, we recommend downloading the latest version of Acrobat Reader?,?.

 

 
 
 
 

© 2022 Kepro. All rights reserved.