MedicaidPrior AuthLow impact
Coagadex® (Coagulation Factor X [Human]) (New)
Humana·OH · Hematology, Pediatrics, General Surgery·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for Coagadex (Coagulation Factor X), a specialized blood coagulation factor medication used to treat hereditary Factor X deficiency. This policy requires prior authorization for all Coagadex prescriptions and covers on-demand treatment, perioperative management, and routine prophylaxis for this rare bleeding disorder.
Action Required
Before February 1, 2026: Billing and pharmacy teams must implement prior authorization requirements for Coagadex (Coagulation Factor X) prescriptions for Medicaid Ohio patients. Verify patients have hereditary Factor X deficiency diagnosis and that treatment is for on-demand bleeding control, perioperative management, or routine prophylaxis. Submit prior authorization requests through www.humana.com/PAL for medical coding information. Claims will be denied without proper prior authorization.