MedicaidPrior AuthMedium impact
Coverage of Progesterone Therapy to Reduce the Risk of Preterm Birth
Illinois Medicaid - HFS·IL · OB-GYN, Family Medicine·Provider Notice
Effective date
Mar 1, 2011
We identified it
Jun 21, 2026
Summary
Illinois Medicaid now covers progesterone therapy to prevent preterm birth during weeks 16-36 of pregnancy. Oral and vaginal suppository forms are preferred and don't require prior authorization, while Makena injectable requires prior approval after trying preferred forms for 4 weeks each.
Action Required
Immediately: Update prior authorization procedures for Makena progesterone injections - require 4-week trials of oral and vaginal suppository forms first. Submit prior auth requests via fax (217-524-7264 or 217-524-0404) or hotline (1-800-252-8942). Bill Makena through provider system, not pharmacy. Update billing system to reflect $40.00 maximum reimbursement rate for injectable 17P.