MedicaidPrior AuthMedium impact
MAB2019120402
Pennsylvania Medicaid (DHS)·PA · Cardiology, Family Medicine, Internal Medicine +2 more·Provider Bulletin
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid now requires prior authorization for certain beta blocker prescriptions including non-preferred drugs, quantities exceeding limits, therapeutic duplications, and all Hemangeol prescriptions. This affects pharmacy billing and prescription processing for Medicaid patients.
Action Required
Before January 1, 2020: Pharmacy staff must update systems to flag beta blocker prescriptions requiring prior authorization: non-preferred beta blockers (check PA PDL), quantities exceeding limits, therapeutic duplications with existing beta blockers, and all Hemangeol prescriptions. Ensure prior authorization requests include required clinical documentation per handbook guidelines. Claims will be denied without proper prior authorization.