NOTICES

DEPARTMENT OF
HUMAN SERVICES

Pharmacy Prior Authorization

[52 Pa.B. 7980]
[Saturday, December 24, 2022]

 The Department of Human Services (Department) announces it will add Corticotropin; targeted systemic Immunomodulators, Atopic Dermatitis designated as preferred on the Department's Preferred Drug List (PDL); PCSK9 inhibitor Lipotropics, Other designated as preferred on the PDL; and Obesity Treatment Agents designated as preferred on the PDL to the Medical Assistance (MA) Program's list of services and items requiring prior authorization.

 Section 443.6(b)(7) of the Human Services Code (62 P.S. § 443.6(b)(7)) authorizes the Department to add items and services to the list of services requiring prior authorization by publication of notice in the Pennsylvania Bulletin.

 The MA Program will require prior authorization of all prescriptions for Corticotropin; targeted systemic Immunomodulators, Atopic Dermatitis designated as preferred on the PDL; PCSK9 inhibitor Lipotropics, Other designated as preferred on the PDL; and Obesity Treatment Agents designated as preferred on the PDL. These prior authorization requirements apply to prescriptions dispensed on or after January 9, 2023.

 The Department will issue MA Bulletins to providers enrolled in the MA Program specifying the procedures for obtaining prior authorization of prescriptions for Corticotropin; targeted systemic Immunomodulators, Atopic Dermatitis designated as preferred on the PDL; PCSK9 inhibitor Lipotropics, Other designated as preferred on the PDL; and Obesity Treatment Agents designated as preferred on the PDL.

Fiscal Impact

 These changes are estimated to result in minimal savings in the MA Fee-for-Service Program.

Public Comment

 Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received within 30 days will be reviewed and considered for any subsequent revisions to these prior authorization requirements.

 Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania Hamilton Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).

MEG SNEAD, 
Acting Secretary

 Fiscal Note: 14-NOT-1555. No fiscal impact; (8) recommends adoption.

[Pa.B. Doc. No. 22-1986. Filed for public inspection December 23, 2022, 9:00 a.m.]

---

No part of the information on this site may be reproduced for profit or sold for profit.

This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.

---