MedicaidPrior AuthMedium impact
Nursing Home and Long Term Care Pharmacy Prior Authorization Request Process Reminder pdf
Connecticut Medicaid (HUSKY Health)·CT · Geriatrics·Prior Authorization
We identified it
Jun 20, 2026
Summary
This Connecticut Medicaid bulletin reminds long-term care pharmacies and nursing homes of proper prior authorization procedures for pharmacy claims. Key requirements include submitting PA requests within 7 days of denial, using specific forms for different medication types (standard PA form vs. opioid PA form), and obtaining prescriber signatures for controlled substances.
Action Required
Immediately: Long-term care pharmacy staff must ensure PA requests are submitted within 7 days of claim denial using the correct forms from ctdssmap.com. Use the standard Nursing Home & LTC Pharmacy PA Request Form for Early Refill, Brand Medically Necessary, Preferred Drug List, and Optimal Dose denials. Use the separate Opioid PA Form for all long-acting and short-acting opioid requests. Obtain prescriber signatures for all controlled substance PA requests or claims will be denied.