MedicaidPrior AuthMedium impact
MAB2025111303
Pennsylvania Medicaid (DHS)·PA · Allergy & Immunology, Emergency Medicine, Family Medicine +4 more·Provider Bulletin
Effective date
Jan 5, 2026
We identified it
Jun 20, 2026
Summary
Pennsylvania Medicaid is updating prior authorization requirements for epinephrine auto-injectors, changing the therapeutic class name from 'Epinephrine, Self-Injected' to 'Epinephrine, Self-Administered' and clarifying guidelines for non-preferred products. Prior authorization will still be required for non-preferred epinephrine products when preferred options cannot be used for clinical reasons.
Action Required
By January 5, 2026: Pharmacy and prescribing staff must update procedures to use new 'Epinephrine, Self-Administered' terminology in prior authorization requests. Prescribers must document clinical reasons when requesting non-preferred epinephrine products and follow updated handbook guidelines. Check the Pennsylvania Preferred Drug List at papdl.com for current preferred epinephrine products. Prior authorization requests without proper clinical documentation will be denied.