MedicaidCoverageMedium impact
MSA 20-51
Michigan Medicaid - MDHHS·MI·Provider Bulletin
Effective date
Oct 1, 2020
We identified it
Jun 20, 2026
Summary
Michigan is implementing a Single Preferred Drug List (PDL) effective October 1, 2020, requiring all Medicaid Health Plans to follow the same drug formulary as the Fee-for-Service program. This affects prescription drug coverage and prior authorization requirements for Medicaid, Healthy Michigan Plan, CSHCS, and MOMS programs.
Action Required
By October 1, 2020: Billing and clinical teams must verify drug coverage using the Michigan PDL at michigan.magellanrx.com before prescribing. Update prior authorization processes to align with Single PDL requirements. Review existing patients on non-preferred drugs and initiate prior authorization requests for medical necessity on a case-by-case basis. Check Common Formulary details at www.michigan.gov/MCOPharmacy for specific prior authorization criteria.