Superior will be ending any active prior authorizations for Synagis® effective February 1, 2022 for all Superior Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS) and CHIP members to align with HHS guidance. As the season has ended, claims for Synagis® will no longer adjudicate pursuant to the end of the season per VDP guidance.
Superior HealthPlan will require prior authorization for CPT code 81519, Oncology Breast MRNA, for Medicaid, CHIP and Superior HealthPlan Medicare-Medicaid Plan (MMP) members. Superior HealthPlan will utilize Change Healthcare’s InterQual as the medical necessity review criteria. Effective on May 1, 2022