MedicaidPrior AuthLow impact
Cerezyme® (imiglucerase) (New)
Humana·IN · Hematology, Endocrinology, Genetics +1 more·Medicaid
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has introduced a new prior authorization policy for Cerezyme (imiglucerase) effective June 1, 2026, for Indiana Medicaid patients with Type 1 or Type 3 Gaucher disease. This enzyme replacement therapy now requires prior authorization demonstrating treatment is for non-CNS manifestations of the disease.
Action Required
By June 1, 2026: Billing team must update prior authorization requirements for Cerezyme (imiglucerase) for Indiana Medicaid patients. Providers must document that treatment is for non-central nervous system manifestations of Type 1 or Type 3 Gaucher disease. Add prior auth alerts to billing system for this medication. Claims without prior authorization will be denied.