MedicaidPrior AuthLow impact
Adzynma (ADAMTS13, recombinant-krhn) (New)
Humana·OH · Hematology, Internal Medicine, Pediatrics·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for Adzynma (ADAMTS13, recombinant-krhn), a specialty medication for congenital thrombotic thrombocytopenic purpura (cTTP). The policy requires strict diagnostic criteria including genetic testing confirmation and ADAMTS13 activity <10% before approval.
Action Required
Before February 1, 2026: Billing team must update prior authorization workflows for Adzynma prescriptions for Humana Medicaid Ohio members. Ensure providers obtain prior auth through www.humana.com/PAL before prescribing. Claims will be denied without proper authorization meeting all four diagnostic criteria.