MedicaidPrior AuthHigh impact
New Prior Authorization Requirements for Short-Acting Opioid Medications pdf
Connecticut Medicaid (HUSKY Health)·CT · Pain Management, Oncology, Hematology +3 more·Prior Authorization
Effective date
Oct 16, 2019
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (HUSKY plans) now requires prior authorization for short-acting opioid prescriptions exceeding 7 days or when patients exceed 630 MME in 120 days. All opioid prescriptions must include valid ICD-10 diagnosis codes or claims will be denied.
Action Required
Immediately: Update billing system to flag short-acting opioid prescriptions for Connecticut Medicaid patients requiring prior authorization when exceeding 7-day supply or 630 MME threshold. Ensure all opioid prescription claims include valid ICD-10 diagnosis codes or they will deny with NCPDP reject codes 39, 925, or 922. Train providers on new Opioid Prior Authorization Form available at ctdssmap.com. Set up secure web portal access for electronic PA submissions.