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Head and Neck Pathology

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Expected PA Criteria (2026) Stricter Requirements Likely Insurers maintaining coverage are expected to keep or tighten current requirements: BMI 30 or 27 with comorbidity (some plans requiring 35) Typically 6 months documented lifestyle modification 5% weight loss for reauthorization (10% for UHC OSA) Shorter initial authorization periods Electronic PA (ePA) Remains Standard CoverMyMeds continues as the primary ePA platform