Pennsylvania Medicaid implements uniform Preferred Drug List (PDL): Important Information/Solicitation of Input
The Commonwealth’s Department of Human Services (DHS) commenced a statewide uniform PDL on January 1, 2020. These changes were published in previous Society communications prior to its enactment. The newly enacted PDL and revised prior authorization guidelines for these prescribed medications pertain to those Medicaid enrollees within the state’s Fee-for-Service program (FFS) and the Medical Assistance managed care organizations within Health Choices and the Community Health Choices (CHC) program. Information is available via
Concerns Since Implementation/Solicitation of Information
Since the implementation of these new procedures, we have heard from various members about problems with obtaining prior authorizations for certain medications (including stimulants), additional requirements to obtain prior authorizations for patients on existing medications, and/or new prior authorizations never previously required for certain Medication Assisted Treatment medications used to assist individuals in their recovery. Many of you have contacted Terri Cathers, Pharm.D., DHS Pharmacy Director directly to express your concerns or provide details about difficulties you have encountered in obtaining prior authorizations for patient medications.
The Society can act as an intermediary for members and DHS when problems arise during the prior authorization process. Our clinical committee works closely with our executive director to obtain and compile member information that can be sent to DHS to provide temporary remedies and permanent solutions.
If you are encountering problems, please send detailed, redacted information to our office via email (
). If you contact Ms. Cathers directly, please cc Deb so that we can keep on top of the outcome.
Thanks for your dedication to your patients, their families and to our Society. Please contact us if you need more information.