← Back to list
Reminder: Medicare Bridge PA requests aren't processed through Priority Health
Act
immediately
Effective date
Not stated in the notice
Identified
Aug 13, 2026
Summary
Medicare GLP-1 weight loss prior authorization (PA) requests must be submitted through the Medicare GLP-1 Bridge Program, not directly to Priority Health. Prescribers must include obesity diagnosis codes (E66 family) and a Bridge referral note with prescriptions; the pharmacy initiates the eligibility check and PA process through the Bridge program, with determinations made within 72 hours.
Get alerts when payers change rules like this one
We check Priority Health and other payers every day and email you when a change matches your specialty and state.
Get Priority Health alertsPolicy Monitoring is free. No card required.
What to do
immediately · 4 steps
01Billing and clinical staff must redirect all GLP-1 weight loss prior authorization requests away from Priority Health submission.
02Providers: Update prescription templates and EHR order sets to include obesity diagnosis code (E66 family) and standardized note stating 'Send to Bridge for weight management' on all GLP-1 weight loss prescriptions.
03Billing/Prior Auth team: Stop submitting GLP-1 weight loss PA requests directly to Priority Health; educate providers that the pharmacy will handle Bridge program submission after eligibility verification.
04Pharmacy liaison: Coordinate with dispensing pharmacies to confirm they understand the Bridge eligibility check workflow and will route PA requests back to providers correctly.
If missed: Failure to follow the Bridge program process will result in claim denials and delays in patient access to GLP-1 medications for weight management.
Codes mentioned
E66E66.01E66.09E66.1E66.9
Original notice
Reminder: Medicare Bridge PA requests aren't processed through Priority Health
priorityhealth.com · Always check the source before changing claims.