MedicaidPrior AuthHigh impact
Pharmacy Program Updates - January 2022
Alaska Medicaid·AK · Pharmacy, Pain Management, Endocrinology +1 more·Pharmacy
Effective date
Mar 1, 2022
We identified it
Jun 21, 2026
Summary
Alaska Medicaid is updating their Preferred Drug List effective March 1, 2022, with new prior authorization requirements for multiple medications including opioids, COVID treatments, and specialty drugs. ICD-10 codes will be required for certain medications, and the morphine equivalent threshold will be reduced to 100 MME on June 1, 2022.
Action Required
By March 1, 2022: Update billing system to require prior authorization for new medications listed (LEQVIO, OXBRYTA, VYVGART, etc.) and ensure ICD-10 codes are included for Paxlovid, molnupiravir, and C-II opioid prescriptions. By April 1, 2022: Add ICD-10 code requirement for Ozempic claims. By June 1, 2022: Implement new 100 MME cumulative threshold for opioid prescriptions requiring prior authorization. Billing team must download updated PDL and prior authorization forms from Alaska Medicaid website and update encounter forms to remind providers of new requirements.