MedicaidPrior AuthHigh impact
Changes to fee-for-service coverage of provider-administered biologic drugs for severe asthma
Oregon Health Plan·OR · Pulmonology, Allergy & Immunology, Dermatology +1 more·Provider
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Summary
Oregon Health Plan now requires prior authorization for all provider-administered biologic drugs for severe asthma (including FASENRA, DUPIXENT, NUCALA, XOLAIR, and CINQAIR) effective January 1, 2022. Claims without approved prior authorization will be denied.
Action Required
Immediately for ongoing patients: Obtain prior authorization before next scheduled dose of biologic agents for severe asthma. Submit PA requests via phone (888-202-2126), Provider Web Portal, or fax (888-346-0178) with required documentation including ICD-10 codes and treatment history. Claims will be denied without approved PA on file.