When does this change take effect?

This change is effective Jun 1, 2025.

MedicaidPrior AuthHigh impact

DSS Important Message - Hospital Monthly Important Message - 05.19.2025

Q: Who is affected by this change?

This affects Connecticut Medicaid (HUSKY Health) Pulmonology, Allergy & Immunology, Internal Medicine, Pediatrics providers in CT on Medicaid plans.

Connecticut Medicaid (HUSKY Health)·CT · Pulmonology, Allergy & Immunology, Internal Medicine +1 more·Provider Bulletin

Effective date

Jun 1, 2025

We identified it

Jun 20, 2026

Days to comply

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Summary

Connecticut Medicaid (CMAP) has updated Addendum B with 2025 HCPCS code changes effective April 1, 2025, added 50 new ICD-10 surgical codes, and implemented new prior authorization requirements for Fasenra and Xolair injections effective June 1, 2025.

Action Required

Action needed

By June 1, 2025: Billing team must implement prior authorization requirements for Fasenra (benralizumab) and Xolair (omalizumab) injections for HUSKY A, C, and D members. Download updated prior authorization forms from www.ctdssmap.com under pharmacy information tab. Update billing system to flag these medications for PA verification before dispensing. Claims submitted without prior authorization will be denied.

Related policy hubs

Connecticut Medicaid (HUSKY Health) policies CT policy changes Pulmonology Allergy & Immunology Internal Medicine Pediatrics