MedicaidPrior AuthMedium impact
2025.59 - New Pharmacy Clinical Prior Authorization Criteria & Forms for Non-Preferred Drugs in 11 Targeted Classes
Connecticut Medicaid (HUSKY Health)·CT · Neurology, Endocrinology, Pulmonology +5 more·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid is implementing new clinical prior authorization requirements for non-preferred drugs in 11 therapeutic classes starting January 1, 2026. Current patients have a 90-day grace period until April 1, 2026, when all prescriptions will require clinical documentation for approval.
Action Required
By March 31, 2026: Providers treating Connecticut Medicaid patients must identify all patients on non-preferred drugs in the 11 specified classes (anticonvulsants, bladder relaxants, MS agents, growth hormones, etc.) and either transition to preferred alternatives or submit new clinical prior authorization forms with supporting documentation. Download new PA forms from ctdssmap.com and fax completed requests to 1-866-759-4110. All previously approved PDL prior authorizations for these classes will expire April 1, 2026.