MedicaidPrior AuthMedium impact
Drug Use Review (DUR) Board approves changes for Physician Administered Drugs (PAD)
Nevada Medicaid·NV · Oncology, Allergy & Immunology, Hematology·Pharmacy
Effective date
Nov 4, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid's Drug Use Review Board has approved updates to prior authorization criteria for physician-administered drugs, specifically adding Yimmugo® to immune globulins coverage and updating clinical criteria for cancer immunotherapy drugs Jemperli®, Keytruda®, and Yervoy®. These changes affect prior authorization requirements for these specific medications.
Action Required
Immediately: Billing team must review updated prior authorization forms at https://gatewaypa.com/ for Yimmugo®, Jemperli®, Keytruda®, and Yervoy®. Update prior authorization processes to reflect new clinical criteria for these physician-administered drugs. Ensure staff are aware of the revised requirements before billing these medications to Nevada Medicaid.