MedicaidPrior AuthMedium impact
Drug Use Review (DUR) Board approves changes effective August 5, 2024
Nevada Medicaid·NV · Hematology, Oncology, Neurology·Pharmacy
Effective date
Aug 5, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has added prior authorization requirements and/or quantity limits for four specialty drugs effective August 5, 2024: two new sickle cell drugs (Lyfgenia® and Casgevy®), Wainua® for certain neurological conditions, and updates to existing drugs Xgeva® and Ocrevus®. Providers must obtain prior authorization before prescribing these medications to Nevada Medicaid patients.
Action Required
Immediately: Providers prescribing Lyfgenia®, Casgevy®, Wainua®, Xgeva®, or Ocrevus® for Nevada Medicaid patients must obtain prior authorization using forms available at https://nevadamedicaid.magellanrx.com/provider/forms before prescribing. Update EMR templates to include prior auth reminder for these drugs. Claims without prior authorization will be denied.