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Prior Authorization

Effective August 1, 2016, Health Partners Plans will require prior authorizations for an expanded list of services performed in an outpatient setting, including those performed in the office, short procedure units, ambulatory surgery centers, clinics, and hospital outpatient departments. This change applies to Health Partners (Medicaid) and Health Partners Medicare, but does not affect KidzPartners (CHIP).

Click here for a complete list of the specific outpatient programs and services that now require prior authorization.

Note: If you are prescribing for a specific member and want to request a non-formulary drug or a formulary drug that requires prior authorization, please use the appropriate forms as indicated on this page. Please note that there are different prior authorizations for Health Partners (Medicaid)/KidzPartners (CHIP) and for Health Partners Medicare. 

Health Partners (Medicaid) and KidzPartners (CHIP)

Prior Authorization Forms:

  • Review this list of Health Partners (Medicaid) and KidzPartners (CHIP) Drug-Specific Prior Authorization Forms. Using one of these forms will help enssure that all necessary information is provided for the requested drug.
  • If the medication you want to request does not have an associated drug-specific form, please complete the Non-Formulary Drug Prior Authorization Form.
  • Fax completed prior authorization requests to 1-866-240-3712.

Health Partners Medicare

Prior Authorization Forms:

  • Review this list of Health Partners Medicare Drug-Specific Prior Authorization Forms. Using one of these forms will help ensure that all necessary information is provided for the requested drug.
  • Fax completed prior authorization requests to 1-866-371-3239.

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