MedicaidPrior AuthMedium impact
Durysta® (bimatoprost implant) (New)
Humana·OH · Ophthalmology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for Durysta® (bimatoprost implant) used to treat open angle glaucoma or ocular hypertension, effective January 1, 2026. The policy requires specific criteria to be met and excludes patients with certain eye conditions like corneal dystrophy or prior corneal transplants.
Action Required
Before January 1, 2026: Billing team must update prior authorization procedures for Durysta (bimatoprost implant) for Humana Medicaid Ohio patients. Verify patients have diagnosis of open angle glaucoma or ocular hypertension, confirm no prior Durysta treatment in the same eye, and ensure no exclusionary conditions (corneal dystrophy, prior corneal transplant, absent/ruptured posterior lens capsule) before administering. Submit prior authorization requests to Humana with required clinical documentation.