MedicaidPrior AuthMedium impact
Policy Updates and Changes to Clinical Review Criteria pdf
Connecticut Medicaid (HUSKY Health)·CT · Pediatrics, Endocrinology, Psychiatry·Provider Bulletin
Effective date
Nov 1, 2022
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (CMAP) has implemented new clinical review criteria effective November 1, 2022, including a new Multi-Marker Serum Testing policy and updates to existing policies for Synagis, genetic sequencing, Zulresso, and Continuous Glucose Monitors. These changes affect prior authorization requirements and coverage criteria for Connecticut Medicaid patients.
Action Required
Immediately: Billing team must review updated clinical review criteria for Multi-Marker Serum Testing, Synagis (Palivizumab), Whole Exome and Whole Genome Sequencing, Zulresso (Brexanolone), and Continuous Glucose Monitors at https://portal.ct.gov/husky under Medical Management policies. Update prior authorization workflows and ensure staff are aware of new medical necessity requirements. Contact CHNCT at 1-800-440-5071 for prior authorization questions.