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    Maryland Department of Health
    Medicaid Pharmacy Program

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    Peer Review Program for Mental Health Medication

    This program was established to address the concerns that an increasing number of children are being prescribed antipsychotics and there is a lack of laboratory monitoring of those children.  The goal of the program is to ensure that children and adolescents receive optimal treatment in conjunction with appropriate non-pharmacologic measures in the safest manner possible.

    This program began in October 2011 and initially addressed the use of antipsychotics in Medicaid patients under five years of age.  In July 2012, it expanded to encompass children under 10 years of age. In 2013, the program began to include all children under the age of 18 years.  

    Below is the planned expansion chart of the program.  If you are requesting a Tier II or Non-Preferred antipsychotic drug for any child within the 10 to 17 year age range, the Tier II and Non-Preferred prior authorization will ONLY be approved for a LIMITED TIME.  The child will then need to be converted into the peer review program.  Based on the schedule below, you will be contacted by someone from the Peer Review Program.

    Thank you in advance for your cooperation during this transition phase.

     

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    Patient Age (Years)

     

    Time Period for Prescriber to Contact Peer Review Program

    Date Prescription Will Start Denying at the Pharmacy

    10


    Early July to Early September

    September 16, 2013

    11


    Early August to Mid October

    October 22, 2013

    12 to 13


    Early September to Mid November

    November 19, 2013

    14 to 15


    Late September to Early December

    December 16, 2013

    16 to 17


    Mid October to Early January

    January 17, 2014

     

    The program works in partnership with the Mental Hygiene Administration (MHA) and the University of Maryland (UMD) School of Pharmacy and Division of Child and Adolescent Psychiatry. 

    The MMPP and the MHA hosted a webinar to discuss the PRP and answer questions regarding this program on September 15, 2011. 

    To view the power point used during the above mentioned webinar, Click here.