MedicaidPrior AuthMedium impact
Provider Letter 2025-01: RE: Prior authorization of icatibant injection — effective Feb. 1, 2025
Oklahoma SoonerCare·OK · Allergy & Immunology, Emergency Medicine, Internal Medicine·Prior Authorization
Effective date
Feb 1, 2025
We identified it
Jun 20, 2026
Summary
Starting February 1, 2025, Oklahoma Medicaid (SoonerCare) will require prior authorization for icatibant injections used to treat hereditary angioedema attacks. Patients currently on therapy will be approved for continuation, but new patients starting after January 1, 2025 need PA requests submitted to avoid treatment disruptions.
Action Required
Before February 1, 2025: Billing team must update system to flag icatibant injections (Firazyr, Sajazir) for prior authorization requirements for SoonerCare members. Submit PA requests using form PHARM-04 (pharmacy) or PHARM-18 (medical) to Pharmacy Prior Authorization Unit via fax. For patients starting therapy after Jan 1, 2025, submit PA immediately with previous dose dates listed. Claims will be denied without proper prior authorization.