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Policy Updates and Changes to Clinical Review Criteria pdf
Connecticut Medicaid (HUSKY Health)·CT · Endocrinology, Vascular Surgery, Pain Management +5 more·Provider Bulletin
Effective date
May 1, 2020
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (CMAP) is retiring multiple medical policies and replacing them with InterQual criteria for review processes, while updating clinical criteria for several other services. Key changes include new separate policies for CAR-T therapies, consolidated footwear policies, and transitions to InterQual criteria for varicose veins, insulin pumps, and glucose monitors.
Action Required
Before May 1, 2020: Billing team must review all claims for CAR-T therapy (Yescarta/Kymriah), diabetic shoes, orthotic footwear, varicose vein procedures, intrathecal pumps, cranial remodeling devices, functional electrical stimulation, Luxturna, organ transplant services, and botulinum toxin treatments to ensure compliance with new policy criteria. Before July 1, 2020: Update prior authorization processes for continuous glucose monitors and external insulin pumps to align with InterQual criteria. Contact CHNCT at 1-800-440-5071 for prior authorization questions.