Medicare AdvantagePrior AuthLow impact
Loargys® (pegzilarginase-nbln) injection solution (New)
Humana·KY, SC, VA · Genetics, Pediatrics, Endocrinology·Medicaid
Effective date
Apr 22, 2026
We identified it
Jun 24, 2026
Summary
Humana has implemented a new prior authorization policy for Loargys (pegzilarginase-nbln) injection, a specialty drug for treating Arginase 1 Deficiency in patients 2 years and older. Prior authorization is required with specific criteria including genetic confirmation of diagnosis, age requirements, and concurrent protein-restricted diet.
Action Required
Before April 22, 2026: Billing team must update prior authorization systems to require pre-approval for Loargys (pegzilarginase-nbln) injection for Humana Medicare and Medicaid plans in Kentucky, South Carolina, and Virginia. Providers treating Arginase 1 Deficiency must obtain prior auth by documenting: genetic confirmation of ARG1-D, patient age 2+ years, and concurrent protein-restricted diet. Claims will be denied without prior authorization.