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Procedures for Prior Authorization of Palivizumab (Synagis®) for Respiratory Syncytial Virus Season 2021-2022
From NC Medicaid: The clinical criteria used by NC Medicaid for the 2021-2022 Respiratory Syncytial Virus (RSV) season are consistent with guidance published by the American Academy of Pediatrics (AAP): 2021 – 2024 Report of the Committee on Infectious Diseases, 32nd Edition. This guidance for Synagis use among infants and children at increased risk of hospitalization for RSV infection is available online by subscription. Providers are encouraged to review the AAP guidance. 
 

Normally a late fall/winter season, due to atypically high levels of circulating RSV, the Synagis coverage season will start Aug. 15, 2021, and last through March 31, 2022. Up to eight monthly doses can be covered. RSV activity will be closely monitored during the eight-month timeframe to determine if the season length should be adjusted.

  • The June 2021 Centers for Disease Control and Prevention (CDC) health advisory notice to notify clinicians and caregivers about increased interseasonal RSV activity across parts of the Southern United States.
  • The North Carolina Division of Public Health (DPH) Epidemiology sections has reported a substantial uptick in the number of RSV cases throughout the state at levels almost to the height of the typical RSV season.
To learn more about the guidelines, coverage limitations, prior authorization requests, etc. -- CLICK HERE.
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