MedicaidCoverageMedium impact
Genetic Testing for Diagnosis of Inherited Conditions - MEDICAID - FLORIDA (Revised)
Humana·FL · Genetics, Neurology, Pediatrics +2 more·Medicaid
Effective date
Apr 6, 2026
We identified it
Jun 24, 2026
Summary
Humana has updated its Florida Medicaid genetic testing policy to expand coverage criteria for diagnosing inherited conditions including adrenoleukodystrophy, CANVAS, muscular dystrophies, and other genetic disorders. The policy requires pre- and post-test genetic counseling and specific clinical criteria to be met for coverage.
Action Required
Before April 6, 2026: Billing team must review and update genetic testing authorization processes for Florida Medicaid members. Ensure pre- and post-test genetic counseling requirements are documented for adrenoleukodystrophy, CANVAS, corneal dystrophy, DRPLA, glycogen storage disease type I, hemophilia B, myotonic dystrophy, Rett syndrome, and spinal/bulbar muscular atrophy cases. Update EMR templates to capture required clinical criteria and family history documentation. Claims may be denied without proper documentation of eligibility criteria.