Medicaid Pharmacy Prior Authorization Fax Number Change

Date: 04/26/22

Heritage Health (Medicaid):

Effective April 27, 2022, the new fax line for Nebraska Total Care pharmacy prior authorizations (PA) for Medicaid services will be 1-833-404-2254.

Please remove pre-printed Nebraska Total Care Medicaid prior authorizations forms with the obsolete fax line, 1-866-399-0929, from circulation on April 26, 2022. The telephone number for Nebraska Total Care pharmacy prior authorizations for Medicaid services will remain the same and is 1-844-330-7852.

To support an efficient PA submission process providers are encouraged to submit requests electronically through CoverMyMeds. Electronic PA submission is a quick and simple way to complete requests, is HIPAA compliant and enables faster determinations. 

Submit ePA Request at: CoverMyMeds.com/main/prior-authorization-forms/