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MedicaidPrior AuthMedium impact

Prior Approval for Atypical Antipsychotics and ADHD Medications for Young Children

Illinois Medicaid - HFS·IL · Psychiatry, Pediatrics, Family Medicine·Provider Notice
Effective date
Aug 24, 2009
We identified it
Jun 21, 2026
Days to comply

Summary

Effective August 24, 2009, Illinois Medicaid will require prior authorization for all ADHD medications prescribed to children under age 6 and all atypical antipsychotic medications for children under age 8. Providers must use specific prior authorization forms and may contact a free child psychiatrist consultation hotline at 1-866-986-2778.

Action Required

Action needed
By August 24, 2009: Providers treating children under 6 with ADHD or children under 8 with atypical antipsychotics must obtain prior authorization using the department's specific forms before prescribing. Update clinical workflows to include prior auth step for these age groups. Contact pharmacy billing consultant at 1-877-782-5565 option 7 for questions. Claims without prior auth will be denied at pharmacy level.