![]() You can get a prior authorization request form faxed to you by contacting the Mercy Care pharmacy prior authorization team at 1-80. You can also print the required prior authorization form and fax it, along with supporting clinical notes to 1-85 for Title 19/21 SMI members or 1-85 for and Non-Title 19/21 members. Mercy Care requires prior authorization for certain drugs on the preferred drug lists and for all drugs not on the preferred drug lists. You may request prior authorization for most drugs via phone by calling the Mercy Care pharmacy prior authorization team at 1‑800‑564-5465. You can use the Integrated Preferred Drug List Search Tool and Behavioral Health Preferred Drug List Search Tool to find out whether a medication is on the preferred drug list. Substance Abuse Block Grant Medication List: For Non-Title 19/21 members with SUDs and primary substance use and misuse.We will cover up to a 7 day supply of drugs on this list with 1 refill. The medications on this list will help stabilize an individual in crisis and bridge them to a follow-up outpatient appointment. Crisis Medication List: For adults or children who are Non-Title 19/21 and Non-SMI who present in crisis at any of the facility-based psychiatric urgent care centers, detox facilities and/or access point in Maricopa, Gila or Pinal counties.Integrated Preferred Drug List: For Title 19/21 SMI members, Mercy Care ACC-RBHA fills physical health and behavioral health medications.Behavioral Health Preferred Drug List: For members who qualify under Title 19/21 Non-SMI or as Non-Title 19/21 determined to have a serious mental illness (SMI), or Non-Title 19/21 children with a serious emotional disturbance (SED), Mercy Care ACC-RBHA fills only behavioral health medications.You can review these preferred drug lists for any restrictions or recommendations before prescribing a medication to a Mercy Care ACC-RBHA member. ![]() Mercy Care ACC-RBHA uses four preferred drug lists, depending on your member’s eligibility. Members can contact Mercy Care Member Services for assistance in locating a pharmacy near them. If you electronically transmit or call in prescriptions for members, be sure the pharmacy is not a Walgreens pharmacy. Walmart, Safeway, Fry’s, Albertson’s and Sam’s Club.Any CVS Pharmacy ® (including those inside Target ® stores).Mercy Care Medicaid network pharmacies include: Dual-eligible members have different options. Members must fill their medications at a network pharmacy. Prescription Drug Benefits Pharmacy Network Members can register for mail order with CVS Caremark at Once they've registered, they can order refills, renew prescriptions and check their orders. Members can call Member Services at 1-80 (TTY 711) to request a mail-order form. Or, download a mail-order service form here: English | Spanish They can start the mail-order process by completing a mail-order request form or signing up online. Patients will ask you to write a prescription for up to a 90-day supply with up to one year of refills. They can get their medications mailed to them. ![]() Your patients don't have to leave their homes to get their medications. ![]()
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