MedicaidPrior AuthMedium impact
Byooviz® (ranibizumab-nuna) (New)
Humana·OH · Ophthalmology·Medicaid
Effective date
Feb 25, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid (Ohio) has implemented a new prior authorization policy for Byooviz (ranibizumab-nuna), a specialty eye injection for macular degeneration and retinal conditions. Prior authorization is required for all three covered indications, with bevacizumab tried first unless contraindicated.
Action Required
Before February 25, 2026: Billing team must update prior authorization workflows for Byooviz (ranibizumab-nuna) injections for Ohio Medicaid patients. Providers must document either contraindication/intolerance to bevacizumab OR prior bevacizumab failure before prescribing Byooviz for wet AMD, macular edema following RVO, or myopic choroidal neovascularization. Submit prior auth requests through Humana's system with required clinical documentation. Claims will be denied without proper prior authorization.