When does this change take effect?

This change is effective Jan 6, 2025.

MedicaidPrior AuthLow impact

MAB2024111303

Q: Who is affected by this change?

This affects Pennsylvania Medicaid (DHS) Family Medicine, Internal Medicine, General Practice, Pain Management, Orthopedics, Neurology +1 more providers in PA on Medicaid plans.

Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, General Practice +4 more·Provider Bulletin

Effective date

Jan 6, 2025

We identified it

Jun 20, 2026

Days to comply

—

Summary

Pennsylvania Medicaid is removing the requirement for prescribers to document searches of the Prescription Drug Monitoring Program when requesting prior authorization for skeletal muscle relaxants. All other prior authorization requirements for these medications remain unchanged.

Action Required

Action needed

By January 6, 2025: Providers and billing staff should note that documentation of Prescription Drug Monitoring Program searches is no longer required when submitting prior authorization requests for skeletal muscle relaxants to Pennsylvania Medicaid. Update any internal checklists or templates that include this requirement.

Related policy hubs

Pennsylvania Medicaid (DHS) policies PA policy changes Family Medicine Internal Medicine General Practice Pain Management Orthopedics Neurology PM&R (Physical Medicine & Rehab)