MedicaidPrior AuthMedium impact
Expansion of the Peer Review Pre-Authorization Program of Antipsychotic Medications for Youth Less than 18 Years Old
Maryland Medicaid·MD · Psychiatry, Pediatrics, Family Medicine +1 more·Pharmacy
We identified it
Jun 20, 2026
Summary
Maryland Medicaid is expanding its peer review pre-authorization program for antipsychotic medications prescribed to patients under 18 years old. This change requires additional clinical review and approval before certain antipsychotic prescriptions can be filled for pediatric patients.
Action Required
Immediately: Providers prescribing antipsychotic medications to patients under 18 must obtain peer review pre-authorization through Maryland Medicaid before prescriptions can be filled. Update clinical workflows to include pre-authorization step for pediatric antipsychotic prescriptions. Billing team should verify authorization status before processing related claims to avoid denials.