MVP Medicaid SGLT2 Coverage

Sep 17, 2026

This document provides critical notification to healthcare providers regarding the prior authorization requirements for Farxiga coverage for MVP Health Care (MVP) NY Medicaid members, effective January 1, 2022. It outlines the necessity for clinicians to submit prior authorization requests supported by appropriate clinical documentation, specifically for FDA-approved indications such as heart failure management, type 2 diabetes with cardiovascular risk factors, and chronic kidney disease treatment. Providers are guided through multiple submission channels, including the Novologix online tool, traditional fax-based forms, and digital platforms like Surescripts or CoverMyMeds. Furthermore, the notice encourages the use of alternative formulary medications, such as Segluromet and Steglatro, which do not require prior authorization, and directs providers to the MVP website for comprehensive formulary information and administrative resources to ensure compliance and patient access to necessary therapies.

LanguageEnglish

CategoryLetters

FormatPDF

Pages1

AccessFree to download

Prior Authorization for Farxiga

Submission Methods

FDA-Approved Indications

FAQs

What is the requirement for Farxiga coverage for NY Medicaid members?

As of January 1, 2022, providers must obtain prior authorization for Farxiga and submit supporting clinical documentation.

Are there alternatives to Farxiga that do not require prior authorization?

Yes, MVP recommends considering formulary alternatives such as Segluromet and Steglatro, which are available without prior authorization.

What are the ways to submit a prior authorization request?

Requests can be submitted via the Novologix online tool, by faxing the appropriate MVP form to 1-800-376-6373, or through Surescripts.com and CoverMyMeds.com.

Sep 17, 2026

Upload by supergirl