MedicaidAdministrativeLow impact
MAB2020111604
Pennsylvania Medicaid (DHS)·PA · Pediatrics, Pharmacy·Provider Bulletin
Effective date
Jan 5, 2021
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid updated their Synagis (palivizumab) prior authorization guidelines to remove an outdated American Academy of Pediatrics website reference. No other changes were made to the medical necessity requirements or prior authorization process.
Action Required
No action required. This is an administrative update that only corrected a website reference in the Synagis prior authorization guidelines without changing any billing or clinical requirements.