J1580 Insurance Policy Changes

IVIG (immune globulin) (Revised)

Humana revised its IVIG (immune globulin) pharmacy coverage policy effective January 1, 2026, with updates as of July 22, 2026. The policy clarifies prior authorization requirements, preferred product selections, and clinical criteria for coverage across 24 IVIG formulations for Medicare and Medicaid (Kentucky and South Carolina) members. Key requirements include step therapy with preferred products unless prior therapy/intolerance documented, specific clinical thresholds (e.g., IgG levels, platelet counts), and condition-specific approval criteria for 22 listed indications.