MedicaidPrior AuthMedium impact
Tisagenlecleucel (KymriahTM) and Voretigene Neparvovec-rzyl (LuxturnaTM) Coverage Guidelines pdf
Connecticut Medicaid (HUSKY Health)·CT · Oncology, Hematology, Ophthalmology·Provider Bulletin
Effective date
Apr 1, 2018
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (HUSKY Health) now requires prior authorization for two specialty gene therapies: Kymriah (tisagenlecleucel) for certain leukemia patients under 25 and Luxturna (voretigene neparvovec-rzyl) for specific retinal dystrophy. Providers must use specific procedure codes and submit PA requests with clinical documentation.
Action Required
By April 1, 2018: Billing team must obtain prior authorization for Kymriah using procedure code Q2040 and Luxturna using procedure code C9399 for all HUSKY Health members. Download PA forms from www.ct.gov/husky and fax completed forms to CHNCT at (203) 265-3994. Ensure clinical documentation supporting medical necessity is included or requests will pend for 20 business days and may be denied.