MedicaidPrior AuthMedium impact
MAB2021111004
Pennsylvania Medicaid (DHS)·PA · Pulmonology, Allergy & Immunology, Family Medicine +2 more·Provider Bulletin
Effective date
Jan 3, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) is implementing revised prior authorization requirements for inhaled glucocorticoids (inhaled steroids) effective January 3, 2022. The changes clarify when prior authorization is required for therapeutic duplication and update medical necessity criteria for non-preferred drugs, quantity limits, and combination therapies.
Action Required
By January 3, 2022: Billing team must update prior authorization workflows for Pennsylvania Medicaid patients receiving inhaled glucocorticoids (inhaled steroids). Verify preferred drug list status before dispensing, check for therapeutic duplication with other inhaled medications, and ensure proper documentation of medical necessity for non-preferred drugs or quantity limit overrides. Review the updated PA guidelines at the provided DHS pharmacy services links.