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IVIG (immune globulin)
Act
by Jan 1, 2026
Effective date
Jan 1, 2026
Identified
Jun 24, 2026
Summary
Humana has implemented a comprehensive prior authorization policy for IVIG (immune globulin) products effective January 1, 2026, covering multiple Medicare and Medicaid lines of business. The policy establishes preferred product lists, specific clinical criteria for 25+ medical conditions, and requires prior authorization for all IVIG treatments with detailed approval criteria for each indication.
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What to do
by Jan 1, 2026 · 4 steps
01Billing team must implement prior authorization requirements for all IVIG products before administering treatments.
02Update systems to flag preferred products (Flebogamma DIF, Gammagard, Gammagard S/D, Gammaked, Gamunex-C, Octagam, Privigen) and require documentation of specific clinical criteria for each indication.
03Providers must document qualifying diagnoses, lab values (IgG levels), prior treatments, and platelet counts where applicable.
04Claims without proper prior authorization will be denied.
Original notice
IVIG (immune globulin)
mcp.humana.com · Always check the source before changing claims.
Related changes
See all Humana changes →IVIG (immune globulin) (Revised)HighEffective Jan 1, 2026 · MedicaidIVIG (immune globulin) (Revised)HighEffective Jan 1, 2026 · MedicaidIVIG (immune globulin) (Revised)HighEffective Jul 1, 2024 · MedicaidIVIG (immune globulin) (Revised)HighEffective Jan 1, 2026 · MedicaidBrowse every Humana change in the policy list