MedicaidPrior AuthMedium impact
MAB2022111006
Pennsylvania Medicaid (DHS)·PA · Dermatology, Allergy & Immunology, Pediatrics +1 more·Provider Bulletin
Effective date
Jan 9, 2023
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) is implementing new prior authorization requirements for atopic dermatitis immunomodulator medications including topical PDE4 inhibitors, JAK inhibitors, and targeted systemic drugs. The policy establishes specific step therapy requirements and medical necessity criteria that must be documented before prescribing these medications.
Action Required
By January 9, 2023: Providers prescribing atopic dermatitis immunomodulators must obtain prior authorization for non-preferred drugs, quantities exceeding limits, topical PDE4/JAK inhibitors, and targeted systemic medications. Document therapeutic failure of required step therapies (4-week topical corticosteroid and 8-week topical calcineurin inhibitor trials) before prescribing advanced treatments. Ensure targeted systemic medications are prescribed by or in consultation with dermatologists. Claims will be denied without proper prior authorization.