MedicaidPrior AuthMedium impact
MAB2022110807
Pennsylvania Medicaid (DHS)·PA · Gastroenterology, Family Medicine, Internal Medicine +1 more·Provider Bulletin
Effective date
Jan 9, 2023
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid has updated prior authorization requirements for GI Motility chronic medications, removing the requirement for patients with diarrhea-related conditions to fail a low FODMAP diet before approval and simplifying renewal requirements by removing tolerability documentation.
Action Required
By January 9, 2023: Billing and prior authorization staff must update Pennsylvania Medicaid prior authorization procedures for GI Motility chronic agents. Remove low FODMAP diet failure requirement for diarrhea-related conditions and simplify renewal documentation requirements. Update internal prior authorization checklists and staff training materials to reflect the streamlined guidelines.