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Prior Authorization MERCY MARICOPA INTEGRATED CARE TXIX/XXI SMI MEDICAID Medicaid This fax machine is located in a secure location as required by HIPAA regulations. 5. Is requested for the treatment of osteoporosis in a man or a postmenopausal woman 2. 5 SD standard deviations below normal T-score 2. 2. Does the patient have osteoporosis If no then no further questions. 3. Has the patient received for 5 years or more Reference Number C6581-A/ Effective Date 02/22/2017 worsened OR has the...
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