MedicaidPrior AuthMedium impact
New Prior Authorization Request Form for Orkambi
Connecticut Medicaid (HUSKY Health)·CT · Pulmonology, Pediatrics, Family Medicine +1 more·Prior Authorization
Effective date
Nov 1, 2015
We identified it
Jun 20, 2026
Summary
Effective November 1, 2015, Connecticut Medicaid (HUSKY programs) requires prior authorization for Orkambi prescriptions using a new specific PA form. The drug treats cystic fibrosis in patients 12+ with F508del mutation and requires genetic testing confirmation.
Action Required
By November 1, 2015: Billing team and providers must use the new Orkambi PA Request Form (available at www.ctdssmap.com) for all Connecticut HUSKY A, B, C, and D patients requiring Orkambi. Providers must document patient age 12+ and genetic testing confirmation of F508del mutation. Claims will be denied without proper prior authorization.