Medicaid_Insulinglargine300_062525
Policy governs prior authorization criteria, quantity limit, and coverage duration for Insulin Glargine 300 units/ml for Medicaid members of Neighborhood Health Plan of Rhode Island.
No material clinical/coverage changes
Coverage Summary
Coverage stance: covered_with_criteria for Insulin Glargine 300 units/ml (Toujeo) under the Medicaid plan of Neighborhood Health Plan of Rhode Island. Scope: this policy governs prior authorization criteria, quantity limit, and coverage duration for Insulin Glargine 300 units/ml for Medicaid members. Prior authorization criteria require that all approval conditions are met (patient age ≥ 6 years; diagnosis of diabetes mellitus; patient requires ≥ 100 units of insulin per day). Quantity limit: 1 ml/day. Coverage duration when authorized: 12 months. Effective date: 7/1/2025. Last review: 6/25/2025.
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