MedicaidPrior AuthMedium impact
Pharmacy Program Updates September 2023
Alaska Medicaid·AK · Pharmacy, Pain Management, Neurology +5 more·Pharmacy
Effective date
Nov 1, 2023
We identified it
Jun 21, 2026
Summary
Alaska Medicaid is updating their Preferred Drug List effective November 1, 2023, and adding 29 new medications to the prior authorization list. New clinical prior authorization criteria are being established for specific high-cost medications including gene therapies and specialty drugs.
Action Required
By November 1, 2023: Billing team must update prior authorization workflows for 29 new medications listed, including Roctavian, Zolgensma, Skyclarys, Tezspire, and various adalimumab biosimilars. Review updated Alaska Medicaid PDL at dhss.alaska.gov and ensure prior authorization is obtained before prescribing these medications. For opioid prescriptions exceeding 150MME, obtain prior authorization and ensure ICD-10 codes are included for C-II opioid claims adjudication.