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NEBRASKA MEDICAID PROGRAM REQUEST FOR PRIOR AUTHORIZATION OF PAYMENT GlucagonLike Peptide1 Receptor Agonists (GLP1 RA) (NOTE: GLP1 RA approved after this bulletin shall be subject to these criteria.)
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How to fill out glp-1 receptor agonists?

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Individuals with type 2 diabetes: glp-1 receptor agonists are commonly prescribed for individuals with type 2 diabetes who have not achieved adequate blood sugar control with oral medications or other diabetes treatments. These medications can help improve blood sugar levels and reduce the risk of complications associated with diabetes.
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People striving for weight loss: Some glp-1 receptor agonists are also approved for weight management in addition to diabetes treatment. Individuals who have a body mass index (BMI) above a certain threshold and are struggling with weight loss may benefit from glp-1 receptor agonists as part of a comprehensive weight management plan.
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Patients with cardiovascular risk factors: Certain glp-1 receptor agonists have been shown to have cardiovascular benefits in individuals with underlying cardiovascular disease or high cardiovascular risk. These medications may be recommended for patients with a history of heart disease, stroke, or other cardiovascular risk factors.
Note: The specific eligibility and appropriateness of glp-1 receptor agonists may vary depending on individual medical conditions, overall health, and other factors. It is essential to consult with a healthcare professional to determine if glp-1 receptor agonists are suitable for you.

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