MedicaidPrior AuthHigh impact
Upcoming Changes to Prior Authorization Process for Physician-Administered Drugs – Effective January 1, 2026
Arkansas Medicaid·AR·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Dec 19, 2025
Summary
Arkansas Medicaid is transferring physician-administered drug (PAD) prior authorization processing from AFMC to Prime Therapeutics effective January 1, 2026. Providers must submit PAD PA requests electronically through CoverMyMeds or by fax to Prime Therapeutics. Additionally, any modifications to existing PAs will now require new PA numbers instead of allowing modifications under the same PA number.
Action Required
REQUIREMENTS:
- By December 31, 2025: Billing team must register with CoverMyMeds (https://www.covermymeds.health/) if planning to submit electronic PAD PA requests. Contact CoverMyMeds Help Desk at 1-866-452-5017 for registration assistance.
- Effective January 1, 2026: Billing team must redirect ALL PAD prior authorization requests to Prime Therapeutics (not AFMC). Submit electronically via CoverMyMeds or fax to 800-424-7976 using the PAD PA form at https://ar.primetherapeutics.com/documents/d/arkansas/arrx_general_pad_form-1.
- Effective January 1, 2026: Update internal workflows to require new PA numbers for ANY modifications to existing PADs. Billers must obtain and document updated PA numbers when changes are made to previously authorized PADs. Failure to obtain new PA numbers for modifications may result in claim denials.
- Immediately: Notify all providers and clinical staff of the new submission process and deadline for CoverMyMeds registration.
- Maintain contact information for billing issues (unchanged) and use Arkansas Medicaid Pharmacy Portal (https://ar.primetherapeutics.com/home) or call 800-424-7895 for questions about the new process.