MedicaidPrior AuthMedium impact
July 1, 2016 Changes to the Connecticut Medicaid Preferred Drug List (PDL), Reminder About the 5 day Emergency Supply and Billing Clarification for Brand Name Medications on the Preferred Drug List (PDL)
Connecticut Medicaid (HUSKY Health)·CT·Pharmacy
Effective date
Jul 1, 2016
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid updated their Preferred Drug List (PDL) effective July 1, 2016, requiring prior authorization for non-preferred medications. Pharmacists can dispense a one-time 14-day supply using specific NCPDP codes (all 9's in field 462-EV and '1' in field 461-EU) while PA is pending, plus a 5-day emergency supply option is available.
Action Required
By July 1, 2016: Billing team must update pharmacy billing system to require prior authorization for all non-preferred Connecticut Medicaid drugs. Configure system to allow 14-day override using NCPDP field 462-EV (all 9's) and field 461-EU (value '1'). Train pharmacy staff on new DAW code requirements: use DAW '5' or '9' for preferred brand medications instead of DAW '1' unless medically necessary documentation exists. Failure to obtain proper authorization will result in claim rejections.