MedicaidPrior AuthMedium impact
MAB2026020402
Pennsylvania Medicaid (DHS)·PA · Oncology, General Surgery, Plastic Surgery +2 more·Provider Bulletin
Effective date
Feb 4, 2026
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid now requires prior authorization for ALL breast and nipple prostheses prescriptions effective immediately. Providers must submit medical records documenting mastectomy or lumpectomy for breast cancer treatment, plus additional documentation for replacement prostheses.
Action Required
Immediately: All providers prescribing breast and nipple prostheses must obtain prior authorization through PROMISe system before dispensing. Submit medical records documenting mastectomy/lumpectomy for breast cancer treatment. For replacement prostheses, also include documentation of loss or irreparable damage. Update billing workflows to require prior auth for all breast prostheses claims to avoid denials.