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New Non-invasive Prenatal Testing for Fetal Aneuploidy Prior Authorization Request Form pdf

Connecticut Medicaid (HUSKY Health)·CT · OB-GYN, Family Medicine·Prior Authorization
Effective date
Feb 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid (HUSKY Health) now requires providers to use a specific prior authorization form for non-invasive prenatal testing for fetal aneuploidy. The form must be completed by the ordering provider and faxed by the laboratory to CHNCT for approval.

Action Required

Action needed
By February 1, 2019: Providers ordering non-invasive prenatal testing for fetal aneuploidy must complete the new HUSKY Health prior authorization form (POPPR-OT54433-1118). Laboratories must fax completed forms to CHNCT at (203) 265-3994. Update workflows to ensure proper form completion including risk factors documentation and patient counseling confirmation. Claims without proper prior authorization will be denied.