Provider Related Links

Atypical Antipsychotics Prior Authorization Request Form
Use this form when requesting any non-preferred atypical antipsychotic.

Georgia Watch Form
The new Georgia Watch Form replaces the FDA Med Watch Form for Georgia Medicaid-Peach Care members. Providers should complete and submit this form to request the brand name drug of a multiple source generic product.

Medicaid Management Information System (MMIS) FAQs

Medicaid Management Information System (MMIS) Implementation

Medical Care Advisory Committee

Medical Care Advisory Committee Members

Proton Pump Inhibitor Appeal Form
Use this form to submit an appeal to obtain authorization for use of a Proton Pump Inhibitor for any DCH plan member - State Health Benefit Plan, Board of Regents.

Statin Appeal Form
Use this form to submit an appeal to obtain a non-preferred Statin or Lipid Lowering Agent for any Medicaid or PeachCare member.