MedicaidPrior AuthMedium impact
MAB2020110902
Pennsylvania Medicaid (DHS)·PA · Neurology, Psychiatry, Pediatrics +3 more·Provider Bulletin
Effective date
Jan 5, 2021
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) is implementing new prior authorization requirements for anticonvulsants, particularly clonazepam prescriptions. Key changes include requiring prior auth for clonazepam in patients under 21, when there's therapeutic duplication with other benzodiazepines, or when prescribed with buprenorphine for opioid use disorder.
Action Required
Before January 5, 2021: Providers prescribing anticonvulsants must obtain prior authorization for clonazepam in patients under 21, when prescribed with other benzodiazepines, or with concurrent buprenorphine treatment. Update clinical workflows to check PDMP and ensure proper documentation of medical necessity. Pharmacy staff should verify prior authorization requirements before dispensing these medications to avoid claim denials.