MedicaidPrior AuthMedium impact
Provider Letter 2022-21: Prior Authorization of Neulasta® – Effective October 15, 2022
Oklahoma SoonerCare·OK · Oncology, Hematology·Prior Authorization
Effective date
Oct 15, 2022
We identified it
Jun 20, 2026
Summary
Effective October 15, 2022, Oklahoma Medicaid (SoonerCare) now requires prior authorization for Neulasta® (pegfilgrastim) while several other G-CSF products remain preferred without PA requirements. Existing patients on Neulasta® therapy can continue, but new starts after July 31, 2022 should submit PA requests to avoid therapy disruption.
Action Required
Immediately: Update billing system to flag Neulasta® (pegfilgrastim) as requiring prior authorization for Oklahoma Medicaid patients. Submit PA requests using form PHARM-208 for patients who started therapy after July 31, 2022, including dates of previous doses. Route all pharmacy PA requests to fax number on form, not to Medical Authorization Unit or provider portal. Consider switching new patients to preferred alternatives like Nyvepria™, Ziextenzo®, Granix®, Neupogen®, or Zarxio® which do not require PA.