MedicaidPrior AuthHigh impact
Alaska Medicaid Pharmacy Program Update April 2022
Alaska Medicaid·AK · Pain Management, Neurology, Rheumatology +4 more·Pharmacy
Effective date
May 1, 2022
We identified it
Jun 21, 2026
Summary
Alaska Medicaid is implementing major pharmacy changes including a 50% reduction in opioid MME threshold (from 150 to 100), new prior authorization requirements for multiple specialty medications, and updated Preferred Drug List effective June 1, 2022.
Action Required
By May 1, 2022: Update prior authorization workflows for OCREVUS, AVSOLA, INFLECTRA, REMICADE, RENFLEXIS, and HETLIOZ. By June 1, 2022: Implement new 100 MME cumulative threshold for opioid prescriptions requiring prior authorization, ensure ICD-10 codes are included on all C-II opioid prescriptions, and add prior authorization requirements for SOLIRIS, ULTOMIRIS, EXONDYS 51, AMONDYS 45, VYONDYS 53, VILTEPSO, KRYSTEXXA, ZULRESSO, QUVIVIQ, BONJESTA, and TOLVAPTAN. Download updated PDL and prior authorization forms from Alaska Medicaid website.