MedicaidPrior AuthMedium impact
MAB2019120502
Pennsylvania Medicaid (DHS)·PA·Provider Bulletin
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid is updating prior authorization requirements for oral glucocorticoids effective January 1, 2020. The clinical review guidelines remain the same, but the format has been updated and now requires prior auth for non-preferred drugs and quantities exceeding limits.
Action Required
By January 1, 2020: Billing team must ensure prior authorization is obtained for all non-preferred oral glucocorticoids and quantities exceeding limits for Pennsylvania Medicaid patients. Check the PA Preferred Drug List at papdl.com before prescribing. Update workflow to verify quantity limits at the provided DHS website. Claims without proper prior authorization will be denied.