MedicaidCoverageMedium impact
Coverage of Synagis and Rotashield
Maryland Medicaid·MD · Pediatrics, Family Medicine, General Practice·Managed Care Organizations
Effective date
Feb 19, 1999
We identified it
Jun 20, 2026
Summary
Managed Care Organizations (MCOs) are now required to expand their formularies to cover two new FDA-approved medications: Synagis (palivizumab) for RSV prevention in high-risk pediatric patients and RotaShield for rotavirus vaccination in infants and children. Both medications must be covered when appropriately prescribed.
Action Required
Immediately: Billing team must verify that Synagis (palivizumab) and RotaShield are added to MCO formularies and covered when appropriately prescribed for pediatric patients. Contact MCO pharmacy services at 410-767-1455 with coverage questions. Update billing systems to reflect new coverage for these medications.