Community Health Plan of Washington (CHPW) requires prior authorization and formulary exception for certain professionally administered medications
These professionally administered drugs require prior authorization. Review CHPW’s Clinical Coverage Criteria for these drugs. For medications that are listed as requiring prior authorization but do not have CHPW Clinical Coverage Criteria, MCG guidelines will be used to determine medical necessity.
Submitting a prior authorization request for professionally administered drugs
ONLINE (preferred) through the Care Management Portal (JIVA)
Request a Care Management Portal account to check eligibility and authorization status, print approval letters, and submit requests online 24/7.