The Pennsylvania Department of Human Services (DHS) has a statewide preferred drug list (PDL) (PDF). Keystone First follows the DHS PDL for drugs and drug classes that are included on the PDL. Keystone First will also cover additional medications that are not on the DHS PDL as a part of our Supplemental Formulary.
Please use the following links to find additional information on the DHS PDL and the Keystone First Supplemental Formulary:
Opioid treatment resources
Keystone First continues to carefully review and update our requirements for opioid prescriptions. Our collaborative goal with you is to ensure that our members are receiving the correct treatment for their pain and that opioid utilization is managed and monitored appropriately. We will continue to provide you with the most up-to-date information and resources to attain that goal.
Opioid-related prior authorization request forms:
- Long-acting opioid prior authorization form (PDF)
- Short-acting opioid prior authorization form (PDF)
- Opioid dependence treatments (oral) prior authorization form (PDF)
Did you know you can now submit all pharmacy prior authorization requests online?
Our online PA request form is fast, easy and best of all, requires no user IDs or passwords. Remember to bookmark this page for future reference.
Pharmacy prior authorization
Pharmacy prior authorizations are required for pharmaceuticals that are not in the formulary, not normally covered, or which have been indicated as requiring prior authorization.