MedicaidPrior AuthLow impact
Enspryng® (satralizumab-mwge) (Revised)
Humana·IN · Neurology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has established a new prior authorization policy for Enspryng (satralizumab-mwge) for Medicaid members in Indiana. The medication requires prior auth for treating Neuromyelitis Optica Spectrum Disorder (NMOSD) and patients must be anti-aquaporin-4 antibody positive with specific clinical characteristics.
Action Required
Before January 1, 2026: Billing team must update prior authorization procedures for Enspryng (satralizumab-mwge) prescriptions for Indiana Medicaid patients. Providers must verify patients are anti-aquaporin-4 antibody positive and document at least one core clinical characteristic of NMOSD (optic neuritis, acute myelitis, area postrema syndrome, acute brainstem syndrome, symptomatic narcolepsy, or symptomatic cerebral syndrome) before submitting prior auth requests. Claims will be denied without proper authorization.