MedicaidPrior AuthMedium impact
2023.76 Provider Bulletin - 01.01.2024 Changes to the PDL - 5 day Emergency Supply - Billing for Brand Name Meds - Pharmacy Web PA pdf
Connecticut Medicaid (HUSKY Health)·CT·Pharmacy
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid updated their Preferred Drug List (PDL) effective January 1, 2024, with changes to preferred medications, prior authorization requirements, and billing procedures for brand name drugs. Key changes include new DAW code requirements for preferred brand medications and clarified emergency supply procedures.
Action Required
Immediately: Pharmacy and billing staff must update procedures for Connecticut Medicaid claims to use DAW codes 5 or 9 (instead of DAW 1) when dispensing preferred brand medications unless prescriber specifically writes 'Brand Medically Necessary' in handwriting. Update staff on 5-day emergency supply option (call 1-866-409-8386) when 14-day override has been used. Ensure documentation requirements for DAW 1 claims to avoid recoupment during audits.