Topic

Translarna (ataluren)

A collection of 12 issues

How to Get Translarna (Ataluren) Covered by Humana in New York: Timeline, Appeals & Required Documentation

Quick Answer: Getting Translarna (Ataluren) Covered by Humana in New York Timeline: 14 days for standard prior authorization (reducing to 7 days in 2026), 72 hours for urgent requests. Requirements: Genetic testing confirming nonsense mutation DMD, 6-minute walk test results, specialist prescription, and annual renewal documentation. First step: Contact your

Renewing Translarna (Ataluren) Coverage with Humana in California: 2025 Requirements and Timeline

Answer Box: Renewing Translarna (Ataluren) with Humana in California Renewal Timeline: Submit renewal requests 30-60 days before your current prior authorization expires to avoid coverage gaps. Humana requires updated clinical documentation showing continued ambulatory function and treatment response. Key Requirements: 6-minute walk test results, current clinical notes, adherence documentation, and

How to Get Translarna (Ataluren) Covered by Aetna CVS Health in Washington: Complete Appeals Guide with Forms and Timelines

Quick Answer: Translarna (ataluren) is typically excluded from Aetna's standard formularies, requiring a formulary exception request with detailed genetic testing documentation and clinical justification. In Washington, you have 60 days to file internal appeals and can request external review through the state's Independent Review Organization (IRO)

How to Get Translarna (Ataluren) Covered by Aetna CVS Health in Texas: Prior Authorization Guide and Appeal Process

Quick Answer: Getting Translarna (Ataluren) Covered in Texas To get Translarna (ataluren) covered by Aetna CVS Health in Texas, you'll need prior authorization due to its specialty status and high cost. Start by having your prescriber submit a prior authorization request through CVS Caremark's system, including

How to Get Translarna (Ataluren) Covered by Cigna in California: Complete Prior Authorization Guide

Answer Box: Getting Translarna (Ataluren) Covered by Cigna in California Translarna (ataluren) is not FDA-approved but may be available through expanded access programs. For Cigna coverage in California: (1) Submit prior authorization via Cigna's California-specific form to fax 1-866-873-8279, (2) Include genetic testing confirming nonsense mutation DMD and

Getting Translarna (Ataluren) Covered by Blue Cross Blue Shield in Texas: Complete Prior Authorization and Appeals Guide

Answer Box: Getting Translarna Coverage in Texas Translarna (ataluren) is not FDA-approved and therefore not covered by Blue Cross Blue Shield of Texas as of 2024. However, if FDA approval occurs, coverage will require: (1) genetic confirmation of nonsense mutation DMD, (2) prior authorization through BCBS provider portal, and (3)

Humana's Coverage Criteria for Translarna (Ataluren) in Texas: Complete Guide to Medical Necessity and Appeals

Answer Box: Getting Translarna (Ataluren) Covered by Humana in Texas Current Status: Translarna is not yet FDA-approved in the US (pending 2024 NDA review). For Texas residents with Humana coverage: 1. Monitor FDA approval status - PTC Therapeutics resubmitted their application in late 2024 2. Prepare documentation now - genetic

How to Get Translarna (Ataluren) Covered by Aetna CVS Health in Georgia: Complete Coding, Prior Authorization, and Appeals Guide

Answer Box: Getting Translarna (Ataluren) Covered by Aetna CVS Health in Georgia Translarna (ataluren) requires prior authorization from Aetna CVS Health with strict medical necessity criteria: confirmed nonsense mutation DMD, ambulatory status, age 2+, and specialist prescription. If denied, you have 180 days for internal appeal and 60 days for

Getting Translarna (Ataluren) Covered by Cigna in Michigan: Complete Forms Guide and Appeals Process

Answer Box: Quick Path to Translarna Coverage To get Translarna (ataluren) covered by Cigna in Michigan: Your doctor must submit the Michigan Prior Authorization Request Form FIS 2288 with complete clinical documentation. Cigna must respond within 15 days (or 72 hours for expedited requests). If denied, you have 180 days

How to Get Translarna (Ataluren) Covered by Aetna CVS Health in Virginia: Complete Timeline and Appeals Guide

Answer Box: Getting Translarna Covered by Aetna CVS Health in Virginia Important: Translarna (ataluren) is not FDA-approved in the United States as of 2025. However, if you're seeking coverage through expanded access or clinical trials, here's the fastest path: 1. Confirm genetic testing shows nonsense mutation