MedicaidPrior AuthMedium impact
MAB2023110902
Pennsylvania Medicaid (DHS)·PA · Endocrinology, Family Medicine, Internal Medicine +2 more·Provider Bulletin
Effective date
Jan 8, 2024
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) is adding Tubeless Insulin Delivery Devices to their Preferred Drug List effective January 8, 2024, requiring prior authorization for non-preferred devices and quantities exceeding limits. Prior authorizations will be approved for 6-month periods.
Action Required
By January 8, 2024: Billing and clinical staff must implement prior authorization requirements for Tubeless Insulin Delivery Devices prescribed to Pennsylvania Medicaid patients. Update pharmacy systems to flag non-preferred devices and quantities exceeding limits. Providers must document medical necessity when requesting non-preferred devices, including why preferred devices cannot be used for medical reasons. Prior authorizations will be valid for 6 months and must be renewed accordingly.