MedicaidPrior AuthMedium impact
Prior Authorization of Anticonvulsants – Pharmacy Services MAB 01-19-06
Pennsylvania Medicaid (DHS)·PA · Neurology, Psychiatry, Family Medicine +2 more·Prior Authorization
Effective date
Jan 28, 2019
We identified it
Jun 20, 2026
Summary
Pennsylvania Medical Assistance (Medicaid) updated prior authorization requirements for anticonvulsant medications, making it easier to get non-preferred drugs approved by changing the requirement from failing 4 preferred drugs to just showing failure, contraindication, or intolerance to preferred options.
Action Required
By January 28, 2019: Pharmacy and prescribing staff must update prior authorization procedures for anticonvulsants. When requesting non-preferred anticonvulsants, document therapeutic failure, contraindication, or intolerance to preferred options (no longer need to show failure of 4 specific drugs). Verify FDA approval, age-appropriate labeling, and check for 90-day prescription history. Update prior auth request forms and staff training materials.