MedicaidPrior AuthMedium impact
Changes to the Prior Authorization Process for Genetic Testing Services
Connecticut Medicaid (HUSKY Health)·CT · Oncology, OB-GYN, Family Medicine +1 more·Prior Authorization
Effective date
Apr 1, 2017
We identified it
Jun 20, 2026
Summary
Effective April 1, 2017, HUSKY Health (Connecticut Medicaid) retired all existing genetic testing prior authorization policies and replaced them with McKesson's InterQual Molecular Diagnostics Criteria. The prior authorization submission process remains the same, but requests lacking sufficient clinical information will be pended for up to 20 business days before potential denial.
Action Required
By April 1, 2017: Billing team must review the laboratory fee schedule at www.ctdssmap.com to identify which molecular pathology and genetic diagnostic procedures require prior authorization (marked with 'Y' in PA column). Ensure all genetic testing prior authorization requests include comprehensive clinical and family history documentation and explain how test results will impact patient care plan. Contact CHNCT at 1-800-440-5071 for prior authorization questions.