MedicaidPrior AuthMedium impact
Prior Authorization of Anticoagulants– Pharmacy MAB 011116
Pennsylvania Medicaid (DHS)·PA · Cardiology, Internal Medicine, Family Medicine +2 more·Prior Authorization
Effective date
Jun 6, 2011
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid now requires prior authorization for anticoagulant medications, including the newly added drug Pradaxa, effective June 6, 2011. Providers must follow specific prior authorization procedures and provide medical necessity documentation for all anticoagulant prescriptions in the fee-for-service delivery system.
Action Required
Effective June 6, 2011: Providers prescribing anticoagulants (including Pradaxa) to Pennsylvania Medicaid fee-for-service patients must obtain prior authorization before dispensing. Follow procedures in Section I of the Prior Authorization of Pharmaceutical Services Handbook and provide clinical documentation per Section II guidelines. Pharmacies may dispense emergency supplies without prior authorization when necessary following handbook procedures.