MedicaidPrior AuthLow impact
Alpha-1 Proteinase Inhibitors (Aralast NP®, Glassia®, Prolastin-C®, Zemaira®) (Revised)
Humana·OH · Pulmonology, Internal Medicine·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has revised their prior authorization policy for Alpha-1 Proteinase Inhibitors (Aralast NP, Glassia, Prolastin-C, Zemaira). The policy maintains strict criteria requiring congenital alpha1-antitrypsin deficiency with emphysema, specific phenotypes, and serum concentration thresholds, while excluding IgA deficient patients.
Action Required
Before January 1, 2026: Billing team must ensure prior authorization is obtained for all Alpha-1 Proteinase Inhibitor medications (Aralast NP, Glassia, Prolastin-C, Zemaira) for Ohio Medicaid patients. Verify patient meets all three criteria: congenital alpha1-antitrypsin deficiency with emphysema, appropriate phenotype (PiZZ, PiZ(null), or Pi(null,null)), and required serum alpha-1 antitrypsin concentrations. Claims will be denied without proper prior authorization.