MedicaidPrior AuthLow impact
Adzynma (ADAMTS13, recombinant-krhn) (New)
Humana·IN · Hematology, Oncology, Internal Medicine·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has introduced a new prior authorization policy for Adzynma (ADAMTS13, recombinant-krhn), a medication for congenital thrombotic thrombocytopenic purpura (cTTP). Coverage requires meeting four specific criteria including confirmed diagnosis, plasma ADAMTS-13 activity <10%, genetic testing confirmation, and negative antibody testing.
Action Required
Before February 1, 2026: Billing team must update prior authorization procedures for Adzynma (ADAMTS13, recombinant-krhn) for Indiana Medicaid patients. Ensure providers understand the four required criteria: cTTP diagnosis, plasma ADAMTS-13 activity <10 IU/dL, confirmed ADAMTS13 mutation via genetic testing, and negative ADAMTS13 antibody testing. Add prior auth requirements to billing system and update encounter forms to prompt documentation of these criteria.