MedicaidPrior AuthMedium impact
2024.63 - Provider Bulletin - 01.01.2025 Changes to the Connecticut Medicaid Preferred Drug List
Connecticut Medicaid (HUSKY Health)·CT·Pharmacy
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid updated their Preferred Drug List (PDL) effective January 1, 2025, with changes to preferred and non-preferred medications across multiple drug classes. New billing clarifications allow pharmacies to use DAW codes 5 or 9 when dispensing preferred brand medications without requiring Brand Medically Necessary documentation.
Action Required
By January 1, 2025: Review the updated Connecticut Medicaid PDL changes on ctdssmap.com to identify which medications now require prior authorization. Update pharmacy billing systems to properly use DAW codes 5 or 9 for preferred brand medications instead of DAW code 1 unless Brand Medically Necessary is documented. Ensure staff understand the 14-day temporary supply override process using all 9's in NCPDP field 462-EV and numeric value 1 in field 461-EU. Train prescribers on the Web PA tool for submitting prior authorization requests.