MedicaidPrior AuthHigh impact
Changes to the CT Medicaid Preferred Drug List pdf
Connecticut Medicaid (HUSKY Health)·CT·Pharmacy
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid has updated their Preferred Drug List (PDL) effective January 1, 2020, with new prior authorization requirements for non-preferred medications. Pharmacists can provide a one-time 14-day supply without prior authorization, and specific billing rules now apply for preferred brand name medications.
Action Required
By January 1, 2020: Billing team must update systems to handle Connecticut Medicaid PDL changes - configure prior authorization requirements for non-preferred medications, enable 14-day temporary supply billing using all 9's in Prior Authorization Number field (NCPDP 462-EV) and numeric '1' in Prior Authorization Type field (NCPDP 461-EU). Update DAW code processing to use codes '5' or '9' for preferred brand medications instead of requiring DAW '1'. Train staff on new 5-day emergency supply option available through 1-866-409-8386. Claims for non-preferred medications without proper authorization will be denied.