Form HCA13-0059 Voretigeme Neparvovec-Rzyl (Luxturna) Authorization Request - Washington

Form HCA13-0059 Voretigeme Neparvovec-Rzyl (Luxturna) Authorization Request - Washington

What Is Form HCA13-0059?

This is a legal form that was released by the Washington State Health Care Authority - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form HCA13-0059?A: Form HCA13-0059 is a form used to request authorization for Voretigeme Neparvovec-Rzyl (Luxturna) in the state of Washington.

Q: What is Voretigeme Neparvovec-Rzyl (Luxturna)?A: Voretigeme Neparvovec-Rzyl, also known as Luxturna, is a medication used to treat a rare inherited retinal disease.

Q: Who can use Luxturna?A: Luxturna is approved for use in patients with confirmed biallelic RPE65 mutation-associated retinal dystrophy.

Q: Why is authorization required for Luxturna?A: Authorization is required to ensure that Luxturna is being used appropriately for patients who meet the specific criteria.

Q: How can I request authorization for Luxturna?A: You can request authorization for Luxturna by completing and submitting Form HCA13-0059.

Q: Is Luxturna covered by insurance?A: Coverage for Luxturna may vary depending on your insurance provider. Please check with your insurance company for specific details.

Q: Are there any alternatives to Luxturna?A: It is best to consult with your doctor or healthcare provider for information on alternative treatment options.

Q: What should I do if my authorization request is denied?A: If your authorization request is denied, you can appeal the decision or discuss alternative options with your healthcare provider.

Q: Is Luxturna available in Canada?A: Yes, Luxturna is also available in Canada. Please consult with a healthcare professional for more information on availability and coverage.

Q: Can Luxturna cure retinal dystrophy?A: Luxturna is not a cure for retinal dystrophy, but it can improve vision in patients with confirmed biallelic RPE65 mutation-associated retinal dystrophy.

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Form Details:

  • The latest edition provided by the Washington State Health Care Authority;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form HCA13-0059 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.

Download Form HCA13-0059 Voretigeme Neparvovec-Rzyl (Luxturna) Authorization Request - Washington

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