Medicare AdvantagePrior AuthLow impact
Oxervate® (cenegermin) ophthalmic solution (New)
Humana·Ophthalmology·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has implemented a new prior authorization policy for Oxervate (cenegermin) ophthalmic solution, effective January 1, 2026. This medication requires prior authorization for neurotrophic keratitis treatment, with approval limited to 8 weeks of treatment per affected eye(s) and specific renewal criteria.
Action Required
By January 1, 2026: Billing and clinical teams must obtain prior authorization from Humana Medicare Advantage before prescribing or billing for Oxervate (cenegermin) ophthalmic solution. Ensure patient has diagnosed neurotrophic keratitis and treatment request does not exceed 8 weeks per affected eye. For renewals, verify patient has not previously received 8 weeks of treatment. Visit www.humana.com/PAL for specific prior authorization procedures and medical coding information.