Effective April 1st 2017, all HUSKY genetic testing medical policies will be retired. McKesson’s InterQual® Molecular Diagnostics Criteria will instead be used in conjunction with the Department of Social Services (DSS) definition of Medical Necessity. The criteria provide evidence-based clinical decision support for molecular and genetic tests. While there will be no change to the prior authorization submission process itself, more detailed information will be required to facilitate person-centered, medical necessity determinations that will support high quality, cost-effective outcomes. Clinical validity, utility and efficacy will all be considered in determining if the test being requested is medically appropriate.
The following are examples of documentation that will be required from the ordering provider as part of the medical necessity review process:
This portion of the HUSKY Health website is managed by Community Health Network of Connecticut, Inc., the State of Connecticut’s Medical Administrative Services Organization for the HUSKY Health Program. For the general HUSKY website gateway, please visit www.ct.gov/husky. HUSKY Health includes Medicaid and the Children’s Health Insurance Program, and is administered by the Connecticut Department of Social Services.
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To see whether you belong to HUSKY A, B, C, D, or LB simply look at your HUSKY ID Card. The big, bold letter is your HUSKY program.