MedicaidPrior AuthMedium impact
Updated Preauthorization and Billing Instructions for Zolgensma®
Maryland Medicaid·MD · Neurology, Pediatrics, Genetics·Provider Transmittal
We identified it
Jun 20, 2026
Summary
Maryland Medicaid has updated preauthorization and billing instructions for Zolgensma®, a gene therapy treatment. This affects how providers must obtain approval and submit claims for this high-cost specialty medication.
Action Required
Immediately: Review the updated Maryland Medicaid provider transmittal for Zolgensma® preauthorization requirements. Billing team must update prior authorization workflows and ensure compliance with new billing instructions. Contact Maryland Medicaid for specific requirements if treating eligible patients.