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January 2023 Iowa Medicaid Pharmacy Program changes

IHCA received informational letter (IL) 2405 from the Iowa Department of Health and Human Services (DHHS) and Iowa Medicaid announcing Iowa Medicaid Pharmacy Program changes, effective Jan. 1, 2023. The letter includes changes to the preferred drug list (PDL), new drug prior authorization (PA) criteria, changes to existing PA criteria, point of sale billing updates and a Drug Utilization Review (DUR) update.

Click here to see the changes.

Providers are encouraged to go to the Preferred Drug List (PDL) website to view all recent changes to the list.

For questions, contact the Pharmacy Prior Authorization Helpdesk at 877-776-1567, or 515-256-4607 if you’re local in Des Moines.

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