MedicaidPrior AuthMedium impact
Briumvi intravenous solution (New)
Humana·OH · Neurology, Internal Medicine, Family Medicine·Medicaid
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Ohio Medicaid now covers Briumvi (ublituximab) intravenous solution for multiple sclerosis treatment, but requires prior authorization. The drug must be used for relapsing forms of MS or clinically isolated syndrome, with initial and renewal approvals lasting one plan year each.
Action Required
By December 1, 2025: Billing team must update prior authorization workflows for Briumvi infusions for Ohio Medicaid patients. Verify patients have relapsing MS or clinically isolated syndrome diagnosis before scheduling. Submit prior auth requests through Humana's system with appropriate diagnosis documentation. Claims will be denied without prior authorization.