MedicaidPrior AuthLow impact
LAMZEDE® (velmanase alfa-tycv) (New)
Humana·LA · Genetics, Pediatrics, Internal Medicine·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has implemented a new prior authorization policy for LAMZEDE® (velmanase alfa-tycv), an enzyme replacement therapy for alpha-mannosidosis. This rare disease treatment requires prior authorization approval for non-central nervous system manifestations, with initial approval for one plan year duration.
Action Required
By January 1, 2026: Billing team must implement prior authorization requirements for LAMZEDE® (velmanase alfa-tycv) infusions for Louisiana Medicaid patients. Update billing system to flag this medication for prior auth when treating alpha-mannosidosis with non-CNS manifestations. Visit www.humana.com/PAL for specific medical and procedural coding requirements. Claims without prior authorization will be denied.