MedicaidPrior AuthMedium impact
Prior Authorization of Calcium Channel Blockers – Pharmacy Services MAB 01-19-20
Pennsylvania Medicaid (DHS)·PA · Cardiology, Family Medicine, Internal Medicine +1 more·Prior Authorization
Effective date
Jul 8, 2019
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid now requires prior authorization for calcium channel blocker prescriptions when there's duplicate therapy (patient already has a recent claim for another calcium channel blocker), in addition to existing requirements for non-preferred drugs and quantity limits. This applies to all Pennsylvania Medicaid fee-for-service patients.
Action Required
Effective July 8, 2019: Providers prescribing calcium channel blockers to Pennsylvania Medicaid patients must obtain prior authorization when the patient has a recent paid claim for another calcium channel blocker. Update prescribing workflows to check for duplicate therapy and document medical necessity for concomitant use, titration, or tapering. Failure to obtain prior authorization will result in claim denials at point-of-sale.