MedicaidPrior AuthMedium impact
2024.34 - Provider Bulletin - 07.01.2024 Changes to the Connecticut Medicaid Preferred Drug List PDF
Connecticut Medicaid (HUSKY Health)·CT·Pharmacy
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid updated their Preferred Drug List (PDL) effective July 1, 2024, with changes to preferred and non-preferred medications. Key billing changes include clarified DAW coding requirements for preferred brand medications and updated prior authorization processes for non-preferred drugs.
Action Required
Immediately: Billing team must update pharmacy billing procedures for Connecticut Medicaid patients. For preferred brand medications on PDL, use DAW code '5' (pharmacy dispensed brand as generic) or '9' (substitution allowed but Medicaid requests brand) instead of '1' unless prescriber specifically indicates 'Brand Medically Necessary' in writing. Update staff on new 14-day temporary supply override process using all 9's in Prior Authorization Number field (NCPDP 462-EV) and '1' in Prior Authorization Type field (NCPDP 461-EU). Ensure prescribers are aware of Web PA tool availability at ctdssmap.com for prior authorization requests.