MedicaidPrior AuthMedium impact
Prior Approval Requests for Synagis Continued through September 30, 2021
Illinois Medicaid - HFS·IL · Pediatrics, Pulmonology·Provider Notice
Effective date
Sep 3, 2021
We identified it
Jun 20, 2026
Summary
Illinois Medicaid is extending the deadline for Synagis (palivizumab) prior authorization requests through September 30, 2021, due to sustained RSV prevalence. Providers must complete Drug Authorization Request Forms and fax to the Pharmacy Unit for fee-for-service patients, while managed care patients require approval through their respective plans.
Action Required
By September 30, 2021: Billing team must ensure all Synagis (palivizumab) requests for Illinois Medicaid fee-for-service patients include completed Drug Authorization Request Forms faxed to 217-524-7264. For managed care patients, contact the appropriate plan for approval guidance. Without proper prior authorization, claims will be denied.