MedicaidPrior AuthMedium impact
Provider Letter 2023-15: RE: Prior Authorization of NYVEPRIA™ – Effective September 1, 2023
Oklahoma SoonerCare·OK · Oncology, Hematology·Prior Authorization
Effective date
Sep 15, 2023
We identified it
Jun 20, 2026
Summary
Oklahoma Medicaid (SoonerCare) now requires prior authorization for NYVEPRIA™ (pegfilgrastim-apgf) effective September 15, 2023. Patients already on NYVEPRIA therapy will be approved for continuation, but new starts after July 31, 2023 should have prior authorization submitted to avoid therapy disruption.
Action Required
By September 15, 2023: Billing team must obtain prior authorization for all new NYVEPRIA™ (pegfilgrastim-apgf) prescriptions for SoonerCare members using form PHARM-208. Submit PA requests for members who started therapy after July 31, 2023 to avoid disruption. Include dates of previous doses on PA form. Submit all requests to Pharmacy Prior Authorization Unit via fax, not Medical Authorization Unit or provider portal.