If you are a physician prescribing Farxiga for any of your patients that have NY MVP Medicaid Coverage, this blog post is for you!
Farxiga may be considered for coverage when used for one of the applicable FDA-approved indications including:
- For the reduction of heart failure hospitalizations in adults with Type 2 diabetes mellitus and
established cardiovascular (CV) disease or multiple CV risk factors
- For the treatment of heart failure with reduced ejection fraction (NYHA classes II to IV) to
reduce the risk of cardiovascular death and hospitalization for heart failure
- For the treatment of chronic kidney disease to reduce the risk of sustained eGFR decline, endstage kidney disease, cardiovascular death, and hospitalization for heart failure in those at-risk
of disease progression
There are 2 other medications that are on the MVP Formulary that do not require prior authorization (such as Segluromet and Steglatro).
If the patient requires Farxiga then the physician needs to obtain a prior authorization.
Please follow the steps: (ALL requests have to have documentation submitted to support the use of Farxiga)
A. Visit mvphealthcare.com/Providers and Sign In to your Provider online account to use the new electronic prior authorization tool powered by Novologix®.
B. Complete the appropriate MVP prior authorization form, which can be accessed at
mvphealthcare.com/Providers, then select Forms, then under Prior Authorization, select the appropriate form in the Pharmacy section. Then, fax completed request form to MVP at 1-800-376-6373.
C. Submit a request through Surescripts.com or CoverMyMeds.com. ( covermymeds is also available on NAVINET)
Find this type of information useful? Follow my blog for more medical billing and coding guideline updates, medical policy/reimbursement changes and anything else related to healthcare!
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