MedicaidPrior AuthMedium impact
Virginia Medicaid Drug Utilization Review Board Approved Updates and Preferred Drug List Effective July 1, 2026
Virginia Medicaid - DMAS·VA·Prior Authorization
Effective date
Jul 1, 2026
We identified it
Jun 16, 2026
Summary
Virginia Medicaid updated their Preferred Drug List and prior authorization requirements effective July 1, 2026, adding new preferred drugs and moving some brand name drugs to non-preferred status. Billing teams must verify current prior authorization requirements for affected medications and update systems to reflect the new formulary changes.
Action Required
By July 1, 2026: Billing team must update prior authorization tracking systems to reflect new service authorization criteria for 12 traditional DUR drugs (Ensacove™, Hyrnuo®, Inluriyo™, Isturisa®, Jascayd®, Komzifti™, Palsonify™, Pyrukynd®, Recorlev®, Rhapsido®, Vanrafia™ and Voyxact®) and 2 physician administered drugs (Kebilidi™ and Zevaskyn™). Update formulary reference materials to reflect preferred vs non-preferred status changes for hepatitis C agents, immunomodulators, anticoagulants, and other drug classes. Verify current SA requirements at https://www.virginiamedicaidpharmacyservices.com/provider/preferred-drug-list before submitting claims to avoid payment disruptions.