MedicaidPrior AuthHigh impact
2026.09 - Pharmacy Clinical Prior Authorization Criteria and Prior Authorization Forms for Non-Preferred Drugs in 11 Targeted Classes
Connecticut Medicaid (HUSKY Health)·CT · Neurology, Endocrinology, Urology +6 more·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid implemented new clinical prior authorization requirements for non-preferred drugs in 11 therapeutic classes effective January 1, 2026. Providers must now submit specific clinical documentation and use new prior authorization forms instead of simple attestation for these drug classes.
Action Required
By April 1, 2026: Update prior authorization workflows for Connecticut Medicaid patients requiring non-preferred drugs in 11 specified classes (anticonvulsants, bladder relaxants, growth hormones, MS agents, etc.). Download new clinical criteria and PA forms from ctdssmap.com. Train providers to submit detailed clinical documentation via fax to 1-866-759-4110. Update EMR templates to capture required clinical information. Incomplete forms will be denied.