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Get DHS 1144 Instructions 2014-2024

D for obtaining any of the following services/equipment/items: (1) Drugs; (2) EPSDT medically fragile case management, skilled nursing and/or personal care; (3) Incontinence supplies, and (4) Dental services. II. Prior Authorization (PA) No.: On receipt of this 1144 Form, ACS will assign an authorization number. DO NOT WRITE ANTHING HERE. III. Each 1144 has 5 lines for requestors to describe and code the services/items being requested. Thus, if more than 5 lines are needed to identify the se.

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