Conduent helped a Southwestern state’s Medicaid program manage rising GLP-1 drug costs while ensuring appropriate patient access by introducing a point-of-sale diagnosis code requirement. Ozempic was covered only for type 2 diabetes when the correct ICD-10 code was submitted, while Wegovy was restricted to Tribal/IHS pharmacies. The rollout included provider bulletins, claims submission guidance, and help desk training. Results between March and May 2025 included elimination of 72-hour manual prior authorizations, faster access to medications, a drop from 35 to fewer than five manual approvals, 100 new paid claims weekly for approved uses, and improved care coordination.

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