Prior authorization

• 2020 Medical Benefit Drug Prior Authorization Grid
• 2020 Medical Covered Services Prior Authorization Grid
• 2019 Medical Benefit Drug Prior Authorization Grid
• 2019 Medical Covered Services Prior Authorization Grid
• Bed Hold Authorization Request Form
• Cal MediConnect List of Covered Drugs (Formulary)
• Cal MediConnect Part D Coverage Determination Request
• Case Management Referral Form
• Long-Term Care Authorization Form
• Long-Term Care Authorization Form FAQs
• Medi-Cal Formulary
• Prior Authorization Request—Medical Services
• Prior Authorization Request—Prescription Drug
• Transportation Physician Certification Statement