[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-288514-105":53,"doc-detail-288514-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","mvp-medicaid-sglt2-coverage","MVP Medicaid SGLT2 Coverage","","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.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":41,"@type":70,"position":76},"https://docshare.wps.com/template/letters/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/mvp-medicaid-sglt2-coverage/288514/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/mvp-medicaid-sglt2-coverage/288514.png","ImageObject",442,249,{"name":88,"@type":89},"supergirl","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-20","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":47},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What is the requirement for Farxiga coverage for NY Medicaid members?","Question",{"text":108,"@type":109},"As of January 1, 2022, providers must obtain prior authorization for Farxiga and submit supporting clinical documentation.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"Are there alternatives to Farxiga that do not require prior authorization?",{"text":113,"@type":109},"Yes, MVP recommends considering formulary alternatives such as Segluromet and Steglatro, which are available without prior authorization.",{"name":115,"@type":106,"acceptedAnswer":116},"What are the ways to submit a prior authorization request?",{"text":117,"@type":109},"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.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},288514,1789633577,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":40,"category_name":41,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":47,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":125,"read_time":4},962088121634,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","MVP Medicaid SGLT2 Coverage  \nThis is a reminder that as of January 1, 2022, MVP Health Care ® (MVP) requires prior authorization for coverage of Farxiga for NY Medicaid Members. MVP recognizes the unique aspects of each individual treatment plan, and there are alternatives on the MVP Formulary that do not require prior authorization (such as Segluromet and Steglatro) . The MVP Formulary can be found at [mvphealthcare.com/Providers](mvphealthcare.com/Providers), and select Pharmacy, then MVP Formularies.  \nIf a Member 's therapy requires Farxiga, you must complete a prior authorization request, and include clinical documentation to support the use of Farxiga in one the following ways:  \n[A. Visit](A. Visit mvphealthcare.com/Providers)[ mvphealthcare.com/Providers](A. Visit mvphealthcare.com/Providers) and Sign In to your Provider online account to use the new electronic prior authorization tool powered by Novologix ® .  \nB. Complete the appropriate MVP prior authorization form, which can be accessed at [mvphealthcare.com/Providers](mvphealthcare.com/Providers), then select Forms, then under Prior Authorization, select the appropriate form in the Pharmacy section. Then, fax completed request form to MVP at 1-800-376-6373.  \nC. Submit a request through Surescripts.com or CoverMyMeds.com.  \nFarxiga may be considered for coverage when used for one of the applicable FDA-approved indications including:  \n1. For the reduction of heart failure hospitalizations in adults with Type 2 diabetes mellitus and established cardiovascular (CV) disease or multiple CV risk factors  \n2. For the treatment of heart failure with reduced ejection fraction (NYHA classes II to IV) to reduce the risk of cardiovascular death and hospitalization for heart failure  \n3. For the treatment of chronic kidney disease to reduce the risk of sustained eGFR decline, endstage kidney disease, cardiovascular death, and hospitalization for heart failure in those at-risk of disease progression","cbCain5OSJyDUlQ5","https://ap.wps.com/l/cbCain5OSJyDUlQ5","pdf",131136,"English","# Prior Authorization for Farxiga\n## Submission Methods\n## FDA-Approved Indications","[{\"question\":\"What is the requirement for Farxiga coverage for NY Medicaid members?\",\"answer\":\"As of January 1, 2022, providers must obtain prior authorization for Farxiga and submit supporting clinical documentation.\"},{\"question\":\"Are there alternatives to Farxiga that do not require prior authorization?\",\"answer\":\"Yes, MVP recommends considering formulary alternatives such as Segluromet and Steglatro, which are available without prior authorization.\"},{\"question\":\"What are the ways to submit a prior authorization request?\",\"answer\":\"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.\"}]","MVP Medicaid SGLT2 Coverage | PDF"]