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MedicaidPrior AuthMedium impact

MAB2022120902

Pennsylvania Medicaid (DHS)·PA·Provider Bulletin
Effective date
Jan 9, 2023
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania's Statewide Preferred Drug List (PDL) will be updated effective January 9, 2023, affecting which medications require prior authorization and changing preferred/non-preferred drug statuses. This applies to both Fee-for-Service and managed care Medical Assistance programs in Pennsylvania.

Action Required

Action needed
By January 9, 2023: Billing team must review the updated Statewide PDL at https://papdl.com/preferred-drug-list to identify changes in preferred/non-preferred drug statuses and new prior authorization requirements. Update billing software and prior authorization workflows for Medical Assistance patients. Monitor for separate MA Bulletins detailing specific prior authorization guidelines that will be published.