Age Restriction
Defines criteria for authorization of drugs/products when age restrictions are relevant for Neighborhood Health Plan of Rhode Island Medicaid members, including initial approval, continuation, documentation and coverage duration limits.
Reviewed and revised multiple times with the most recent review dated 01/2026; no material clinical policy changes indicated in the revision history.
Coverage Summary
This policy defines authorization criteria for drugs/products when age restrictions apply to Neighborhood Health Plan of Rhode Island Medicaid members. Coverage stance: covered_with_criteria. Key scope statistics: Coverage Duration: Up to 12 months; Scope: Medicaid; Accepted Reference Compendia: American Hospital Formulary Service Drug information (AHFS-DI), Thomson Micromedex DrugDex, Clinical Pharmacology, Wolters Kluwer Lexi-Drugs, and peer-reviewed published medical literature.
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