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2024.38 - Provider Bulletin - Policy Updates and Changes to Clinical Review Criteria PDF

Connecticut Medicaid (HUSKY Health)·CT·Provider Bulletin
Effective date
Aug 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid (CMAP) is implementing multiple policy changes effective August 1, 2024, including 5 new policies for items like donor breast milk and neurostimulators, retiring 2 policies that will now use InterQual criteria, and updating 9 existing policies covering items from breast pumps to compression garments.

Action Required

Action needed
By August 1, 2024: Billing team must review all new and updated policies at https://portal.ct.gov/husky under Medical Management. Update prior authorization workflows for affected services including donor breast milk, anti-embolism stockings, neurostimulators, mechanical stretching devices, medical foods, breast pumps, organ transplants, OXLUMO, Tepezza, Volara System, cosmetic/reconstructive surgery, DME rent-to-purchase, therapeutic footwear, and compression garments. Contact CHNCT at 1-800-440-5071 for prior authorization questions.