MedicaidPrior AuthMedium impact
Korsuva™ (difelikefalin) (New)
Humana·OH · Nephrology·Medicaid
Effective date
May 27, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for Korsuva (difelikefalin) IV solution, effective May 27, 2026, for treating chronic kidney disease-associated pruritus in hemodialysis patients. The policy requires patients to have CKD-associated pruritus and undergo hemodialysis 3+ times weekly for 3 months prior to approval.
Action Required
By May 27, 2026: Billing team must update prior authorization system to require preapproval for Korsuva (difelikefalin) IV solution for Ohio Medicaid patients. Ensure documentation includes CKD-associated pruritus diagnosis and confirmation of hemodialysis 3+ times weekly for previous 3 months. For renewals, document continued hemodialysis schedule and reported improvement in pruritus symptoms. Claims will be denied without proper prior authorization.