MedicaidPrior AuthLow impact
New Prior Authorization Requirement for Evrysdi pdf
Connecticut Medicaid (HUSKY Health)·CT · Neurology, Pediatrics, Family Medicine +1 more·Prior Authorization
Effective date
Jun 1, 2021
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (HUSKY A, B, C, D) now requires prior authorization for Evrysdi (risdiplam) prescriptions effective June 1, 2021. Patients must be 2+ months old with SMA diagnosis, not receiving Spinraza therapy, and show functional decline if previously treated with Zolgensma.
Action Required
Immediately: Pharmacy and prescribing providers must complete the Evrysdi PA form available at www.ctdssmap.com before prescribing risdiplam for Connecticut Medicaid patients. Verify patient meets all four clinical criteria or submit letter of medical necessity to Rx.LMN@ct.gov. Initial authorizations valid for 12 months only.