MedicaidPrior AuthMedium impact
Synagis Policy Statement RSV Season 2014
Georgia Medicaid·GA · Pediatrics, Pulmonology, Cardiology·Pharmacy
Effective date
Oct 1, 2014
We identified it
Jun 20, 2026
Summary
Georgia Medicaid Fee-For-Service has updated their Synagis (palivizumab) policy for RSV season 2014-2015, limiting coverage to a maximum of 5 doses for specific high-risk pediatric populations with strict eligibility criteria. The policy requires prior authorization through Catamaran and only allows prescriber-submitted requests with original signatures.
Action Required
By October 1, 2014: Billing team must ensure all Synagis prior authorizations for Georgia Medicaid FFS members are faxed to Catamaran at 1-888-491-9742 using the specific PA Request Form from the Georgia DCH website. Providers must verify patient eligibility meets strict criteria (preterm <29 weeks and <12 months, or specific chronic conditions) and submit original signatures only - no stamped or copied signatures accepted. Track maximum dose limits based on start month (5 doses max if starting October, decreasing monthly).