MedicaidAdministrativeLow impact
MAB2023111304
Pennsylvania Medicaid (DHS)·PA · Endocrinology, Pharmacy, OB-GYN·Provider Bulletin
Effective date
Jan 8, 2024
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance is updating prior authorization requirements for estrogen prescriptions, specifically updating references to current transgender health standards. The clinical guidelines remain the same, only terminology is being updated to reflect the current World Professional Association for Transgender Health Standards of Care.
Action Required
By January 8, 2024: Review updated Pennsylvania Medical Assistance handbook pages for estrogen prior authorization requirements. No workflow changes needed as clinical guidelines remain unchanged - only terminology updates to reference current transgender health standards. Pharmacy and prescribing staff should be aware of the updated reference materials.