HIV Combinations - Expedited Authorization
Effective immediately, the following Washington Apple Health pharmacy programs have added expedited authorization (EA) criteria for the HIV combination drugs listed below.
- Amerigroup
- Coordinated Care
- Fee-for-Service (FFS)
- Molina
- United Health Care
These EA’s allow pharmacies to submit a claim for continuation of therapy without a prior authorization.
| Product |
Code |
Criteria |
|
Descovy (emtricitabine/tenofovir alafenamide)
|
006 |
Continuation of pre-exposure prophylaxis (PrEP) therapy. |
|
HIV combinations
Biktarvy® (bictegravir/ emtricitabine/tenofovir alafenamide)
Delstrigo™ (doravirine/lamivudine/tenofovir disoproxil)
Descovy® (emtricitabine/tenofovir alafenamide)
Dovato (dolutegravir/lamivudine)
efavirenz/lamivudine/tenofovir disoproxil
Juluca (dolutegravir/rilpivirine)
Symtuza® (darunavir/cobicistat/emtricitabine/tenofovir alafenamide)
Temixys™ (lamivudine/tenofovir disoproxil)
|
007 |
Continuation of antiviral treatment.
|
For clients enrolled in Apple Health managed care plan, contact the client’s plan.
For additional questions, email: AppleHealthPharmacyPolicy@hca.wa.gov
|