MedicaidCoverageLow impact
Coverage of Drug Therapy for AIDS Wasting Syndrome
Maryland Medicaid·MD · Infectious Disease, Internal Medicine, Endocrinology·Managed Care Organizations
Effective date
Feb 4, 2000
We identified it
Jun 20, 2026
Summary
Maryland Medicaid managed care organizations must now include drug therapy for AIDS wasting syndrome (somatropin, oxandrolone, megestrol) on their formularies. MCOs can require preauthorization but must decide within 72 hours and follow established procedures for non-formulary requests.
Action Required
Immediately: Billing teams working with Maryland Medicaid MCO patients should verify that AIDS wasting syndrome medications (somatropin, oxandrolone, megestrol) are covered on plan formularies. Update prior authorization workflows to ensure 72-hour decision timeframes are met. Document medical necessity for non-formulary drug requests to avoid automatic denials.