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MedicaidPrior AuthMedium impact

MAB2021110505

Pennsylvania Medicaid (DHS)·PA · Pulmonology, Family Medicine, Internal Medicine +2 more·Provider Bulletin
Effective date
Jan 3, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medicaid is removing prior authorization requirements for single-ingredient inhaled long-acting bronchodilators/beta agonists and for therapeutic duplication of short-acting bronchodilators/beta agonists. This simplifies prescribing and reduces administrative burden for respiratory medications.

Action Required

Action needed
By January 3, 2022: Update billing system to remove prior authorization requirements for single-ingredient inhaled long-acting bronchodilators/beta agonists and short-acting bronchodilator therapeutic duplications for Pennsylvania Medicaid patients. Review current prior authorization workflows and modify encounter forms to reflect these changes. Staff should be trained on the updated guidelines for remaining bronchodilator prior authorization requirements.