MedicaidPrior AuthMedium impact
ForwardHealth Update 2025-36: January 2026 Preferred Drug List Changes and Other Pharmacy PolicyJanuary 6, 2026: This Update has been revised since its original publication. Revised information appears in red text on pages 10, 29, and 33-34.
Wisconsin ForwardHealth·WI · Family Medicine, Internal Medicine, Urology +2 more·Pharmacy
Effective date
Jan 1, 2026
We identified it
Jun 18, 2026
Summary
ForwardHealth (Wisconsin Medicaid) updated their Preferred Drug List effective January 1, 2026, adding new drug classes and changing prior authorization requirements for multiple medications. Two new antibiotics (Blujepa and Orlynvah) now require clinical prior authorization with specific criteria for female patients with uncomplicated UTIs.
Action Required
By January 1, 2026: Pharmacy providers must use new PA/PDL form F-03412 for Blujepa and Orlynvah prior authorization requests. Update pharmacy systems to require clinical PA for these antibiotics with criteria: female patients only, FDA-approved age/weight, uncomplicated UTI with susceptible organism, alternative oral antibiotics inappropriate. Prescribers must complete and send PA forms to pharmacies, not directly to ForwardHealth.