MedicaidPrior AuthLow impact
VPRIV® (velaglucerase alfa) (New)
Humana·IN · Hematology, Endocrinology, Pediatrics +1 more·Medicaid
Effective date
Mar 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has implemented a new prior authorization policy for VPRIV (velaglucerase alfa), a medication used for Type 1 Gaucher Disease. Prior authorization is required and must demonstrate the patient has Type 1 Gaucher Disease and has had prior therapy, intolerance, or contraindication to Elelyso (taliglucerase).
Action Required
By March 1, 2026: Billing team must establish prior authorization workflow for VPRIV (velaglucerase alfa) for Humana Medicaid Indiana patients. Ensure providers document Type 1 Gaucher Disease diagnosis and prior therapy/intolerance/contraindication to Elelyso before prescribing VPRIV. Claims will require prior authorization approval for coverage.