MedicaidPrior AuthLow impact
Ryplazim (plasminogen, human-tvmh) (New)
Humana·LA · Hematology·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has established a new prior authorization policy for Ryplazim (plasminogen, human-tvmh), a specialized infusion therapy for treating rare plasminogen deficiency Type 1. The policy requires hematologist involvement, specific diagnostic criteria, and documentation of baseline plasminogen activity levels below 45%.
Action Required
Before February 1, 2026: Billing team must update prior authorization system to include Ryplazim (plasminogen, human-tvmh) for Louisiana Medicaid patients. Ensure providers document: 1) Hematologist prescription/consultation, 2) Plasminogen deficiency Type 1 diagnosis, 3) Baseline plasminogen activity ≤45%, and 4) History of hypoplasminogenemia lesions. Claims without proper prior authorization will be denied.