MedicaidPrior AuthMedium impact
2026.26 - Provider Bulletin - 1) July 1, 2026 Changes to the Connecticut Medicaid Preferred Drug List (PDL), 2) Reminder About the 5-day Emergency Supply, 3) Billing Clarification for Brand Name Medications on the Preferred Drug List (PDL), 4) Pharmacy Web PA Tool
Connecticut Medicaid (HUSKY Health)·CT·Pharmacy
Effective date
Jul 1, 2026
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid updated their Preferred Drug List effective July 1, 2026, requiring prior authorization for non-preferred medications. The policy clarifies billing procedures for preferred brand name medications and allows pharmacies to use DAW codes 5 or 9 for brand reimbursement when the brand is preferred on the PDL.
Action Required
By July 1, 2026: Billing team must update pharmacy billing systems to recognize new Connecticut Medicaid PDL changes. Ensure staff know that preferred brand medications can be billed with DAW codes 5 or 9 for brand reimbursement without prior authorization. Train pharmacy staff on 14-day temporary supply override using all 9's in Prior Authorization Number field (NCPDP 462-EV) and numeric value '1' in Prior Authorization Type field (NCPDP 461-EU). Update prior authorization workflows to use the Pharmacy Web PA tool at www.ctdssmap.com for non-preferred medications.