MedicaidPrior AuthMedium impact
MAB2021111001
Pennsylvania Medicaid (DHS)·PA · Dermatology, Allergy & Immunology, Family Medicine +1 more·Provider Bulletin
Effective date
Jan 3, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid now requires prior authorization for all topical PDE4 inhibitors and topical JAK inhibitors used for atopic dermatitis, effective January 3, 2022. These medications must meet specific medical necessity criteria including therapeutic failure of preferred treatments.
Action Required
By January 3, 2022: Billing team must update prior authorization workflows for topical PDE4 inhibitors (like Eucrisa) and topical JAK inhibitors prescribed for atopic dermatitis in Pennsylvania Medicaid patients. Providers must document therapeutic failure or contraindications to topical calcineurin inhibitors for PDE4 inhibitors, and failure of both topical corticosteroids and calcineurin inhibitors for JAK inhibitors. Update encounter forms to remind providers of new documentation requirements. Claims without proper prior authorization will be denied.