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Maryland Department of Health
Medicaid Pharmacy Program

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  • Medicaid Pharmacy Program
    • Pharmacy Prior Authorization (PA) Forms
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    • Antipsychotics Review Programs
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    • Pharmacy and Therapeutics Committee Minutes
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    • Clinical-Criteria
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  • Hepatitis C - Clinical Criteria
  • Hepatitis C - Sample Treatment Plan 
  • Hepatitis C - Sample Enhanced Treatment Plan 
  • Hepatitis C - PA form 
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Maryland Department of Health
201 W. Preston Street, Baltimore, MD 21201
(410)767-6500 or 1-877-463-3464
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