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.
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.
Form Details:
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.