MedicaidPrior AuthLow impact
MAB2022071303
Pennsylvania Medicaid (DHS)·PA · Dermatology, Family Medicine, General Practice +2 more·Provider Bulletin
Effective date
Sep 1, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid is updating prior authorization requirements for topical acne medications, removing automated prior authorization processes. The change primarily affects prescribers and pharmacies but may impact billing for visits where these medications are prescribed or administered.
Action Required
By September 1, 2022: Providers prescribing topical acne agents to Pennsylvania Medicaid patients must follow updated prior authorization procedures. Review the updated Preferred Drug List at papdl.com and ensure prescriptions for non-preferred agents, medications for patients 21+ years old, or quantities exceeding limits include proper medical necessity documentation. Claims may be delayed without proper prior authorization.