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MedicaidPrior AuthLow impact

MAB2022071302

Pennsylvania Medicaid (DHS)·PA · Family Medicine, Internal Medicine, OB-GYN +1 more·Provider Bulletin
Effective date
Sep 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medicaid is updating prior authorization guidelines for contraceptives effective September 1, 2022. The changes clarify language for consistency but do not alter the actual medical necessity requirements for non-preferred contraceptives or quantity limit overrides.

Action Required

Action needed
By September 1, 2022: Review updated PA guidelines for contraceptives in Pennsylvania Medicaid cases. No workflow changes needed as medical necessity criteria remain unchanged - only language clarification for consistency.