Synagis for RSV Season 2008-2009

N.C. Medicaid will begin coverage of Synagis on October 15, 2008. During the season, five monthly doses of Synagis can be obtained.  The number of doses should be adjusted if an infant received the first dose prior to a hospital discharge.  Delays in request processing can occur if the patient does not have a Medicaid identification number or the form is not complete.

Prior approval will not be required for Synagis for the upcoming respiratory syncytial virus (RSV) season.  However, prescribers and pharmacists are responsible for ensuring the appropriate usage of Synagis.  The clinical criteria utilized by N.C. Medicaid are consistent with currently published American Academy of Pediatrics Red Book guidelines (subscription required; or in Red Book:  2006 Report of the Committee on Infectious Diseases, 27th Edition).

Physicians and pharmacy providers are subject to audits of Synagis records by DMA Program Integrity.