7/19/2012
Aetna's most current precertification list can be found on Aetna’s website. Some recent additions to the list include:
- Ventricular Assist Devices – added effective January 1, 2012
- Hepatitis C Oral Medications – added effective September 1, 2011
- Incivek TM (telaprevir)
- Victrelis TM (boceprevir)
To precertify the following drugs and medical injectables, call 1-866-503-0857 or fax the corresponding Medication Request form to 1-888-267-3277. Forms can be located on Aetna's secure provider website, by selecting "Aetna Support Center", then "Forms Library" and "Pharmacy Forms".
- Antiemetics:
- Aloxi IV (palonosetron) - added effective January 1, 2012
- Anzemet IV (dolasetron) - added effective January 1, 2012
- Emend® IV (fosaprepitant) - added effective January 1, 2012
- Soliris® (eculizumab) - added effective January 1, 2012
- ForteoTM (teriparatide) - added effective January 1, 2012
- Yervoy (ipilimumab) – added effective August 1, 2011
- Benlysta® (belimumab) – added effective August 1, 2011
- Multiple Sclerosis medications:
- Avonex®, Rebif® (interferon beta>1a) - added effective January 1, 2012
- Betaseron®, Extavia® (interferon beta>1b) - added effective January 1, 2012
- Copaxone® (glatiramer acetate injection) - added effective January 1, 2012
- GilenyaTM (fingolimod) - added effective January 1, 2012
- Tysabri (natalizumab) - added effective January 1, 2012
- Viscosupplementation:
- Euflexxa® (1 percent sodium hyaluronate) - added effective January 1, 2012
- Hyalgan®, Supartz® (sodium hyaluronate) - added effective January 1, 2012
- Orthovisc® (High Molecular Weight Hyaluronan) - added effective January 1, 2012
- Synvisc®, Synvisc One® (hylan G-F 20) - added effective January 1, 2012