MedicaidPrior AuthLow impact
Prior Authorization of Alpha-1 Proteinase Inhibitors – Pharmacy Services MAB 01-19-08
Pennsylvania Medicaid (DHS)·PA · Pulmonology, Internal Medicine·Prior Authorization
Effective date
Jan 28, 2019
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid has updated prior authorization requirements for Alpha-1 Proteinase Inhibitors, adding Pi*SZ as an example of a high-risk genetic variant for alpha-1 antitrypsin deficiency. The clinical criteria and approval process remain otherwise unchanged.
Action Required
By January 28, 2019: Billing and clinical staff should note that Pi*SZ is now included as an example high-risk genetic variant when documenting prior authorization requests for Alpha-1 Proteinase Inhibitors for Pennsylvania Medicaid patients. Update any internal reference materials or checklists to include this genetic variant alongside Pi*ZZ, Pi*Z(null), and Pi*(null,null).