March 17, 2020
VDP will implement clinical prior authorization criteria for Sunosi (solriamfetol) for traditional Medicaid on April 14. The criteria were approved at the Oct. 2019 Drug Utilization Review Board meeting, and is part of the Central Nervous System Stimulants clinical prior authorization. The drugs Provigil and Nuvigil are already part of this clinical prior authorization.
This clinical prior authorization is optional for the MCOs to implement. The Pharmacy Clinical Prior Authorization Assistance Chart (PDF) shows the prior authorization each MCO uses and how those authorizations relate to the authorizations used for traditional Medicaid claim processing. This chart is updated quarterly.