Topic

Gattex (teduglutide)

A collection of 3 issues

How to Get Gattex (teduglutide) Covered by Blue Cross Blue Shield of Illinois: Prior Authorization, Appeals, and State Protections

Answer Box: Getting Gattex Approved in Illinois To get Gattex (teduglutide) covered by Blue Cross Blue Shield of Illinois, you need prior authorization showing short bowel syndrome with parenteral nutrition dependence. Submit clinical documentation including PN logs, specialist attestation, and failed alternative therapies. If denied, you have 60 days to
6 min read

UnitedHealthcare's Coverage Criteria for Gattex (Teduglutide) in Pennsylvania: What Counts as "Medically Necessary"?

Answer Box: Getting Gattex Covered by UnitedHealthcare in Pennsylvania UnitedHealthcare requires prior authorization for Gattex (teduglutide) with strict medical necessity criteria: documented short bowel syndrome, 12+ months of parenteral nutrition dependence (≥3 days/week), failed enteral optimization attempts, and recent colonoscopy with polyp removal. Fastest path to approval: Submit complete
6 min read