During the 2007 legislative session, the Utah State Legislature passed Senate Bill 42 allowing Medicaid to adopt a preferred drug list (PDL). During the 2009 legislative session, the State Legislature approved SB 87, which authorizes Utah Medicaid to require a Prior Authorization for non-preferred drugs. The PA requirement became effective May 18, 2009. Criteria for a Non-Preferred Authorization (NPA) is posted in the library at the bottom of this page.
Utah belongs to The Sovereign States Drug Consortium (SSDC), a collaborative group of Medicaid states. Collectively members are focused on providing quality pharmaceutical care while controlling costs. The primary activity of the SSDC is to serve as a Medicaid drug rebate pool that negotiates for supplemental rebates. More information about the SSDC can be found at their website.
The Medicaid Preferred Drug List continues to expand on a monthly basis. All preferred drugs and diabetic supplies are NDC specific.
The Utah PDL is not an all inclusive list of Utah Medicaid covered outpatient pharmaceutical agents. Products not listed may or may not be subject to clinical prior authorization requirements or other coverage limitations. Please refer to the the Utah Medicaid Pharmacy Provider Manual for more information.
Updates about the PDL implementation process will be provided through the MIB, and on this website.
These files are provided in PDF format. If you cannot open a file, please click on the image below to install the required plugin.
To use a non-preferred drug, the Non-Preferred Prior Authorization Form must be used.