MedicaidPrior AuthLow impact
MAB2022071402
Pennsylvania Medicaid (DHS)·PA · Endocrinology, Family Medicine, Internal Medicine +1 more·Provider Bulletin
Effective date
Sep 1, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) updated prior authorization requirements for Alpha-Glucosidase Inhibitor diabetes medications, clarifying that non-preferred drugs and quantities exceeding limits require prior authorization. The policy language was revised for clarity but medical necessity guidelines remain unchanged.
Action Required
No immediate action required as this is a clarification of existing prior authorization requirements for Alpha-Glucosidase Inhibitor diabetes medications. Billing team should continue current prior authorization processes for non-preferred hypoglycemic drugs and quantities exceeding limits for Pennsylvania Medicaid patients.