MedicaidPrior AuthMedium impact
Virginia Medicaid Preferred Drug List / Common Core Formulary and New Drug Utilization Board Approved Drug Service Authorizations Effective April 1, 2026
Virginia Medicaid - DMAS·VA · Family Medicine, Internal Medicine, General Practice +7 more·Prior Authorization
Effective date
Apr 1, 2026
We identified it
Jun 16, 2026
Summary
Virginia Medicaid updated its Preferred Drug List (PDL) and Common Core Formulary effective April 1, 2026, adding new prior authorization requirements for 22 traditional and physician-administered drugs, and changing preferred status for multiple drug classes including antipsychotics, muscle relaxants, and bone resorption agents.
Action Required
Before April 1, 2026: Billing team must update prior authorization processes for 22 newly approved drugs including Alyftrek, Attruby, Leqembi, and others listed in the policy. Review updated Virginia Medicaid PDL at virginiamedicaidpharmacyservices.com to identify preferred vs non-preferred medications in affected drug classes. Update billing system to flag non-preferred drugs that may require prior authorization. Providers must obtain service authorization using forms available at the Virginia Medicaid pharmacy services website before prescribing non-preferred medications to avoid claim denials.