SoonerCare uses this universal petition for medication prior authorization when no drug-specific form fits, out of roughly 250 drug-specific forms the Oklahoma Health Care Authority posts. A prescriber meets it when the pharmacy cannot fill a prescription without approval. The completed petition is returned to the prior authorization department of Pharmacy Management Consultants at the University of Oklahoma College of Pharmacy.
The dispensing pharmacy completes Section 1 with pharmacy, drug, NDC, fill and prescriber details and the pharmacist's signature. The prescriber, or the health care provider completing it, fills in Section 2 with the diagnosis, ICD code and previous Tier-1 or OTC trials, then signs.
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SoonerCare Petition for Medication Prior Authorization
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Only when no drug-specific form applies. OHCA posts about 250 forms for individual drugs and classes, numbered PHARM-14 to PHARM-306. Check that list first; the universal petition covers other medications that need prior authorization.
Two people. The pharmacist signs Section 1 after entering the dispensing details, and Section 2 is signed by the prescriber or the individual who completed the clinical information. That signature indicates the diagnosis and prior trial information are accurate and verifiable in the patient's records.