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MedicaidPrior AuthLow impact

MAB2021111504

Pennsylvania Medicaid (DHS)·PA · Neurology, Pharmacy·Provider Bulletin
Effective date
Jan 3, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Pennsylvania Medicaid will no longer require prior authorization for Rilutek (riluzole) in the fee-for-service delivery system, effective January 3, 2022. This removes a previous authorization requirement that was implemented in 2014 due to appropriate utilization patterns and good safety profile.

Action Required

Action needed
By January 3, 2022: Billing and pharmacy staff should update systems to remove prior authorization requirements for Rilutek (riluzole) for Pennsylvania Medicaid fee-for-service patients. Verify that billing software no longer flags this medication for prior auth. Note that managed care organizations may still have their own prior authorization requirements.