Topic

Translarna (ataluren)

A collection of 19 issues

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

How to Renew Translarna (Ataluren) Coverage with UnitedHealthcare in Ohio: Timeline, Documentation & Appeals

Answer Box: Renewing Translarna Coverage in Ohio Translarna (ataluren) requires annual prior authorization renewal with UnitedHealthcare in Ohio. Start the renewal process 60-90 days before your current authorization expires to avoid coverage gaps. Key requirements include updated 6-minute walk test results, genetic confirmation of nonsense mutation DMD, and specialist documentation

How to Get Translarna (Ataluren) Covered by Aetna CVS Health in Michigan: Complete Requirements Guide

Quick Answer: Getting Translarna Covered by Aetna CVS Health in Michigan Translarna (ataluren) requires prior authorization from Aetna CVS Health in Michigan. The fastest path to approval: (1) Submit PA request through Availity portal with genetic testing confirming nonsense mutation DMD, (2) Include ambulatory status documentation and medical necessity letter,