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 now requires prior authorization for Oxervate (cenegermin) ophthalmic solution used to treat neurotrophic keratitis. Coverage is limited to 8 weeks of treatment per affected eye with specific diagnosis requirements.
Action Required
By January 1, 2026: Billing team must obtain prior authorization from Humana Medicare Advantage before prescribing Oxervate (cenegermin) for neurotrophic keratitis patients. Verify diagnosis of neurotrophic keratitis is documented and treatment duration does not exceed 8 weeks per affected eye. Claims will be denied without prior authorization.