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Alabama Medicaid

Updates from Alabama Medicaid

Medicaid PDL Update - January 2018

Effective January 1, 2018, the Alabama Medicaid Agency updated the Preferred Drug List (PDL) to reflect quarterly updates. The updates are listed here:

PDL Additions


HCV Antiviral


HCV Antiviral


HCV Antiviral

PDL Deletions

Viekira XR

HCV Antiviral

For additional PDL and coverage information, visit the Alabama Medicaid Agency drug look-up site.

The PA request form and criteria booklet, as well as a link for a PA request form that can be completed and submitted electronically online, can be found on the Agency’s website at and should be utilized by the prescriber or the dispensing pharmacy when requesting a PA. Providers requesting PAs by mail or fax should send requests to:

Health Information Designs (HID)
Medicaid Pharmacy Administrative Services
P. O. Box 3210 Auburn, AL 36832-3210
Fax: 1-800-748-0116
Phone: 1-800-748-0130

Incomplete PA requests or those failing to meet Medicaid criteria will be denied. If the prescriber believes medical justification should be considered, the prescriber must document this on the form or submit a written letter of medical justification along with the PA form to HID. Additional information may be requested. Staff physicians will review this information.

Policy questions concerning this provider notice should be directed to the Pharmacy Program at (334) 242-5050. Questions regarding PA procedures should be directed to the HID help desk at 1-800-748-0130.

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