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CAR T- Cell Therapy Coverage Guidelines pdf

Connecticut Medicaid (HUSKY Health)·CT · Oncology, Hematology·Provider Bulletin
Effective date
May 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid has implemented new coverage guidelines for CAR T-Cell therapy (KYMRIAH and YESCARTA) effective May 1, 2019. Providers must use new drug-specific prior authorization forms and submit clinical documentation supporting medical necessity for these treatments.

Action Required

Action needed
Immediately: Billing team must obtain and use the new KYMRIAH (tisagenlecleucel) and YESCARTA (axicabtagene ciloleucel) prior authorization request forms available at www.ct.gov/husky under Prior Authorization Forms. Providers must complete and sign forms and submit clinical documentation supporting medical necessity. Respond to requests for additional information within 20 business days to avoid denial.