MedicaidPrior AuthMedium impact
Prior Authorization of Immunomodulators, Atopic Dermatitis – Pharmacy Services MAB 01-19-17
Pennsylvania Medicaid (DHS)·PA · Dermatology, Allergy & Immunology, Pediatrics +1 more·Prior Authorization
Effective date
Jul 8, 2019
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid updated prior authorization requirements for immunomodulators used to treat atopic dermatitis, specifically removing Dupixent from this category (now has separate guidelines) and requiring prior auth for non-preferred topical calcineurin inhibitors and Eucrisa (crisaborole topical).
Action Required
By July 8, 2019: Billing team must update prior authorization procedures for Pennsylvania Medicaid patients receiving immunomodulators for atopic dermatitis. Remove Dupixent from atopic dermatitis prior auth requirements (refer to separate Dupixent guidelines). Ensure prior authorization is obtained for non-preferred topical calcineurin inhibitors and Eucrisa before prescribing. Update encounter forms to remind providers of these requirements. Claims without proper prior authorization will be denied.