MedicaidPrior AuthMedium impact
MAB2022120803
Pennsylvania Medicaid (DHS)·PA · Endocrinology, OB-GYN, Pediatrics +1 more·Provider Bulletin
Effective date
Jan 9, 2023
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid has updated prior authorization requirements for Pituitary Suppressive Agents (LHRH medications). The key change clarifies that patients with a history of depression or suicidal thoughts must have a behavioral health assessment before starting elagolix-containing medications or Myfembree.
Action Required
By January 9, 2023: Billing team must ensure providers obtain behavioral health assessments for Pennsylvania Medicaid patients with depression history before prescribing elagolix-containing medications or Myfembree. Update prior authorization request protocols to include this assessment documentation. All Pituitary Suppressive Agent prescriptions require prior authorization - verify current preferred drug list at papdl.com before submitting requests.