MedicaidPrior AuthMedium impact
Uplizna® (inebilizumab-cdon) (New)
Humana·OH · Neurology, Rheumatology, Allergy & Immunology·Medicaid
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for Uplizna (inebilizumab-cdon), a specialty IV medication used to treat rare neurological and autoimmune conditions including neuromyelitis optica spectrum disorder, IgG4-related disease, and generalized myasthenia gravis. The policy requires specific diagnostic criteria and failed prior therapies before approval.
Action Required
By June 1, 2026: Billing team must update prior authorization requirements for Uplizna (inebilizumab-cdon) in billing system for Humana Medicaid Ohio patients. Providers treating NMOSD, IgG4-related disease, or generalized myasthenia gravis must obtain prior auth before administering Uplizna. Update encounter forms to remind providers of PA requirement. Claims will be denied without proper prior authorization.