MedicaidPrior AuthMedium impact
Izervay™ (avacincaptad pegol) (New)
Humana·OH · Ophthalmology·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
New prior authorization policy for Izervay (avacincaptad pegol) for Ohio Medicaid patients with geographic atrophy secondary to age-related macular degeneration. Prior auth required for this intravitreal injection and must be prescribed by an ophthalmologist or retinal specialist.
Action Required
Before February 1, 2026: Billing team must update prior authorization system to require approval for Izervay (avacincaptad pegol) for Ohio Medicaid patients. Ensure ophthalmology providers document geographic atrophy diagnosis secondary to AMD and that medication is prescribed by or in consultation with ophthalmologist or retinal specialist. Claims will require prior authorization approval.