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All PlansPrior AuthMedium impact

Prior Authorization Requirements for Drugs, Supplies, and Procedures for Sexual Dysfunction or Erectile Dysfunction

Healthfirst·Urology, Endocrinology, Family Medicine +1 more·Prior Authorization
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

New prior authorization requirements have been implemented for all drugs, supplies, and procedures related to sexual dysfunction or erectile dysfunction treatment. Healthcare providers must now obtain prior authorization before providing these services to avoid claim denials.

Action Required

Action needed
Immediately: Billing team must update system to require prior authorization for all sexual dysfunction and erectile dysfunction related drugs, supplies, and procedures. Update encounter forms and EMR templates to remind providers to obtain prior auth before treatment. Contact insurance plans to verify specific authorization procedures. Claims submitted without prior authorization will be denied.