MedicaidPrior AuthMedium impact
Changes to PDL - 5 Emergency Sup - Brand Name Meds - RX Tool pdf
Connecticut Medicaid (HUSKY Health)·CT·Pharmacy
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid updated their Preferred Drug List (PDL) effective January 1, 2021, with new prior authorization requirements for non-preferred medications. Pharmacies can provide one-time 14-day supplies for non-preferred drugs, and a 5-day emergency supply is available after the 14-day override is used.
Action Required
By January 1, 2021: Billing team must update pharmacy billing procedures to require prior authorization for non-preferred medications on Connecticut Medicaid PDL. Train staff on new DAW codes (5 and 9) for preferred brand medications to ensure proper reimbursement. Update systems to handle 14-day temporary supplies using all 9's in Prior Authorization Number field (NCPDP 462-EV) and numeric value '1' in Prior Authorization Type field (NCPDP 461-EU). Failure to obtain proper authorization will result in claim denials.