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Genglycos ™ (Pariglasgene Brecaparvovec-Opnr)
Effective date
Dec 1, 2026
Identified
Nov 7, 2026
Summary
UnitedHealthcare Community Plan of Tennessee added a new medical benefit drug policy for Genglycos (pariglasgene brecaparvovec-opnr) for Medicaid members, effective 2026-12-01. Coverage is limited to patients 8 years or older with glycogen storage disease type Ia who meet diagnosis confirmation, cornstarch therapy, AAV8 antibody, prior gene therapy, specialist, admission, labeling, and single-lifetime authorization limits, with authorization valid for no more than 45 days from approval.
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What to do
Action · 3 steps
01By 2026-12-01: Billing team, before scheduling Genglycos infusions for Tennessee UnitedHealthcare Community Plan Medicaid members, confirm each patient meets the policy criteria and obtain authorization, since the policy states authorization is issued for no more than one lifetime treatment and no longer than 45 days from approval.
02Providers and front desk staff should be told to collect the required records (G6PC variant results or liver biopsy G6Pase deficiency, documentation of cornstarch therapy, AAV8 antibody status, and metabolic specialist involvement) before scheduling, and to avoid requesting a planned inpatient admission solely to administer the drug.
03Update the prior auth tracker and charge entry so claims include the authorization and supporting records; the policy notes that requests not meeting these criteria will not be approved.
Original notice
Genglycos ™ (Pariglasgene Brecaparvovec-Opnr)
uhcprovider.com · Always check the source before changing claims.
Related changes
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