MedicaidPrior AuthMedium impact
Drug Use Review (DUR) Board approves changes effective June 2, 2025
Nevada Medicaid·NV · Endocrinology, Cardiology, Family Medicine +1 more·Pharmacy
Effective date
Jun 2, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has updated prior authorization requirements for Wegovy® (semaglutide) under the Incretin Mimetics drug class. The policy now requires additional documentation of established cardiovascular disease verified by a specialist for coverage approval.
Action Required
By June 2, 2025: Providers prescribing Wegovy® (semaglutide) for Nevada Medicaid patients must obtain specialist documentation verifying established cardiovascular disease before submitting prior authorization requests. Update prior authorization workflow to include cardiovascular specialist verification requirements. Use updated forms from https://nv.primetherapeutics.com/provider/forms.