Medication Prior Authorization Resources

Medication prior authorization information

Prior authorization is required for the clinic-administered medications listed below:

• View the clinic administration medication list
• View the medical benefit PA criteria library
• View additional resources for medical benefit medications

For patients that have pharmacy coverage through Quartz, prior authorization is required for the prescription medications listed in the prescription benefit PA criteria library.

Quartz pharmacy criteria – Large Group – Small Group/Individual

Practitioners must submit a prior authorization request using one of the following ways:

• Online at My Quartz Tools 
• Completed the clinically administered medication prior authorization request form