MedicaidPrior AuthMedium impact
MAB2021110204
Pennsylvania Medicaid (DHS)·PA · Dermatology, Family Medicine, General Practice +2 more·Provider Bulletin
Effective date
Jan 3, 2022
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) now requires prior authorization for non-preferred topical antifungal medications effective January 3, 2022. Prior authorization will be approved if there is documented therapeutic failure, contraindication, or intolerance to preferred topical antifungals for the patient's specific diagnosis.
Action Required
By January 3, 2022: Billing team must update prior authorization tracking system to require PA for non-preferred topical antifungals for Pennsylvania Medicaid patients. Providers must document therapeutic failure, contraindication, or intolerance to preferred agents based on patient's diagnosis. Check the Pennsylvania Preferred Drug List (PDL) at papdl.com to identify which topical antifungals require prior authorization.