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Nusinersen Coverage Guidelines pdf

Connecticut Medicaid (HUSKY Health)·CT · Neurology, Pediatrics, PM&R (Physical Medicine & Rehab)·Provider Bulletin
Effective date
May 1, 2017
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid (HUSKY programs) now requires prior authorization for Nusinersen (Spinraza) prescriptions for spinal muscular atrophy treatment. Prescribers must submit a letter of medical necessity with specific documentation to the Medical Director, and authorization is limited to 6 months with re-authorization required.

Action Required

Action needed
Immediately: Billing team must flag all Nusinersen (Spinraza) prescriptions for HUSKY A, B, C, D, and Family Planning program patients as requiring prior authorization. Providers must fax letters of medical necessity to (860) 424-4822 with required documentation before prescribing. Update billing system to track 6-month authorization periods and set reminders for re-authorization. Claims will be denied without proper prior authorization.