Effective June 1, 2013, all orders for eyeglass lenses, frames, and contact lenses must be submitted to Idaho Medicaid’s new optical products supplier, Classic Optical Laboratories, Inc.. Any Prior Authorization Request which meets criteria and is received in the Medical Care Unit from June 1, 2013, forward, will be approved by Classic Optical.
If you are a Medicaid participant with questions about benefits, please contact your Medicaid vision provider who will be able to assist you based upon your individual medical situation. Molina Medicaid Solutions Customer Service is also available at 1 (866) 686-4272.
Please see the Provider Handbook to the Molina HealthPAS portal for specific information about Vision Benefits. Under Provider Guidelines, see Eye and Vision Services. Vision providers may submit requests, with supporting documentation, for medical conditions which do not meet criteria noted in the handbook. These special requests will undergo review by Medicaid’s Medical Director. For additional information you may also look at Administrative Rule, IDAPA 16.03.09.781-785.
To submit a prior authorization request, please fill out one of the prior authorization forms found in the forms section of this web page. The form must be completed in its entirety and faxed to 1 (877) 314-8779. It is necessary to include both previous and current prescription information on the request form. Vision providers may view the outcome of the review under their Trading Partner Account at HealthPAS and see Authorization Status. You may also contact Molina Medicaid Solutions to check the status at 1 (866) 686-4272.
If you have questions about the changes in vision benefits, please contact the policy subject matter expert for the Division of Medicaid at (208) 364-1818 or you can send us an email. Idaho Medicaid Vision Services are provided on a fee for service basis from local ophthalmologists, optometrists, and opticians. Contacts and eyeglasses which meet Medicaid criteria are provided through a contract with Classic Optical Laboratories, Inc.. For questions about the Classic Optical contract please contact (208) 364-1835. The MCU phone number for vision service questions is (208) 364-1904.