UnitedHealthcareMedicaid · Prior Auth · Medical Benefit Drug Policy · NJ · Genetics, Endocrinology, Pediatrics +1 moreLow impact
Genglycos ™ (Pariglasgene Brecaparvovec-Opnr)
Effective date
Dec 1, 2026
Identified
Nov 7, 2026
Summary
UnitedHealthcare Community Plan of New Jersey published a new Medicaid medical benefit drug policy for Genglycos (pariglasgene brecaparvovec-opnr), a gene therapy for glycogen storage disease type Ia, effective 2026-12-01. Coverage is limited to patients aged 8 or older with a confirmed GSDIa diagnosis (G6PC bi-allelic variants or absent G6Pase activity on liver biopsy), on a current cornstarch regimen, without detectable AAV8 antibodies, no prior gene therapy, prescribed by or with a metabolic specialist, no planned inpatient admission solely for administration, dosed per FDA labeling, and authorized for one lifetime treatment for up to 45 days from approval.
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01By 2026-12-01: Billing team and providers who treat patients with glycogen storage disease type Ia should confirm the practice's Medicaid (New Jersey) prior authorization workflow covers Genglycos requests, gathering genetic test results or liver biopsy enzyme activity reports, cornstarch regimen documentation, AAV8 antibody results, and metabolic specialist involvement before scheduling administration.
02Front desk staff should flag any planned inpatient admission for Genglycos so it can be reviewed against the policy's exclusion; claims for this therapy submitted without these elements will be denied under the policy's terms.
Original notice
Genglycos ™ (Pariglasgene Brecaparvovec-Opnr)
uhcprovider.com · Always check the source before changing claims.
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