May 01, 2023

Maryland Medicaid: New specialty medications require prior authorization

Effective Aug. 1, 2023, we will require prior authorization for the following medications listed with their HCPCS codes:

  • Amvuttra® (vutrisiran) - J0225
  • Enjaymo® (sutimlimab-jome) - J1302
  • Releuko® (filgrastim-ayow) - Q5125
  • Spevigo® (spesolimab-sbzo) - J1747
  • Viltepso® (viltolarsen) - J1427
  • Xenpozyme™ (olipudase alfa-rpcp) - J0218

Affected plans

This affects the following UnitedHealth benefit plans:

  • UnitedHealthcare Community Plan of Maryland

How to submit a request

You can submit a prior authorization request through the UnitedHealthcare Provider Portal:

  • Go to and select Sign In at the top-right corner
  • Sign in to the portal using your One Healthcare ID and password
    – If you are a new user and don’t have a One Healthcare ID, visit to get started
  • In the menu, select Prior Authorizations
  • In the Prior Authorization and Notification tool, scroll down to “Create a new notification or prior authorization request” and click Create New Submissions
  • Enter the required information and submit

Determination and review timeline

We will complete prior authorization reviews according to state-defined requirements. You’ll receive notifications of the case determination, including appeal rights, when applicable, within required time frames.

Your prior authorization requests will be denied if sufficient clinical information is not provided. Please submit all documentation when submitting your requests, according to health plan protocols.


Questions? We’re here to help.

For questions about these prior authorization requirements, call us at 888-397-8129 7 a.m.–7 p.m. CT Monday–Friday.

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