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MedicaidPrior AuthMedium impact

Provider Bulletin - Prior Authorization of Chimeric Antigen Receptor – T Cell Therapy

Connecticut Medicaid (HUSKY Health)·CT · Oncology, Hematology·Prior Authorization
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Effective July 1, 2022, Connecticut Medicaid is removing prior authorization requirements for CAR-T cell therapies (Breyanzi, Kymriah, Tecartus, and Yescarta). However, if these therapies are administered during an inpatient stay, prior authorization is still required for the elective inpatient admission itself.

Action Required

Action needed
Billing team must update prior authorization workflows to remove requirements for CAR-T cell therapy drugs (Breyanzi, Kymriah, Tecartus, Yescarta) for Connecticut Medicaid patients. However, continue to obtain prior authorization for elective inpatient admissions when CAR-T therapy will be administered on an inpatient basis through CHNCT at 1-800-440-5071.