MedicaidPrior AuthLow impact
Fabrazyme® (agalsidase beta) and Elfabrio® (pegunigalsidase alfa) (New)
Humana·IN · Genetics, Nephrology, Cardiology +2 more·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana is implementing a new prior authorization policy for Fabrazyme and Elfabrio, both IV medications used to treat Fabry disease. Prior authorization will be required with documentation of confirmed Fabry disease diagnosis.
Action Required
Before February 1, 2026: Billing team must implement prior authorization requirements for Fabrazyme (agalsidase beta) and Elfabrio (pegunigalsidase alfa) for Indiana Medicaid patients. Ensure providers document confirmed Fabry disease diagnosis for authorization requests. Visit www.humana.com/PAL for medical and procedural coding information and submission process.