MedicaidPrior AuthMedium impact
MAB2021111505
Pennsylvania Medicaid (DHS)·PA·Provider Bulletin
Effective date
Jan 3, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania's Medical Assistance program is implementing updates to the Statewide Preferred Drug List (PDL) effective January 3, 2022, which will affect prior authorization requirements for both preferred and non-preferred medications. The changes apply to all Pennsylvania providers serving Medical Assistance beneficiaries in both Fee-for-Service and managed care delivery systems.
Action Required
Before January 3, 2022: Billing and clinical staff must review the updated Statewide PDL at https://papdl.com/preferred-drug-list to identify changes in preferred/non-preferred drug status and new prior authorization requirements. Update internal formulary references and notify providers of new prior authorization guidelines. For FFS beneficiaries, follow procedures in SECTION I of the Prior Authorization of Pharmaceutical Services Handbook. For managed care beneficiaries, contact specific MCOs for their prior authorization procedures.