Specialty· June 6, 2026 · 14 min readGLP-1 benefit investigation: verify coverage, PA, and specialty pharmacyStep-by-step GLP-1 benefit investigation workflow: formulary lookup, PA criteria, specialty pharmacy routing, benefits verification...By Ran Chen#GLP-1#Benefit Investigation#Prior Authorization
Specialty· June 6, 2026 · 15 min readGLP-1 specialty pharmacy mandatory routing: when your pharmacy can't fill the prescriptionHow payer-mandated specialty pharmacy networks and limited distribution requirements create GLP-1 access barriers — and what patients,...By Ran Chen#GLP-1#Specialty Pharmacy#Pharmacy Benefit
Specialty· June 6, 2026 · 16 min readGLP-1 step therapy exception: document contraindication and prior-therapy failureMaps GLP-1 step therapy by payer, exception docs for contraindication, intolerance, and therapeutic failure, and the exception form...By Ran Chen#GLP-1#Step Therapy#Prior Authorization
Pricing & Access· June 6, 2026 · 9 min readNC Medicaid GLP-1 coverage: PA criteria, PDL status, and the 2025–2026 policy reversalNC Medicaid removed GLP-1 weight-management drugs from the PDL in Oct 2025, then reinstated them Dec 2025. Maps PA criteria, BMI...By Ran Chen#GLP-1#North Carolina Medicaid#Prior Authorization