MedicaidPrior AuthMedium impact
Sinuva® (mometasone furoate) sinus implant (New)
Humana·OH · ENT (Ear, Nose & Throat)·Medicaid
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has established a new prior authorization policy for Sinuva® (mometasone furoate) sinus implants, effective December 1, 2025. Prior authorization will be required for all Sinuva prescriptions for chronic rhinosinusitis with nasal polyps in patients 18 years and older.
Action Required
By December 1, 2025: Billing and prior authorization teams must implement new prior authorization requirements for Sinuva® (mometasone furoate) sinus implants for Ohio Medicaid patients. Update authorization workflows to verify patients have chronic rhinosinusitis with nasal polyps diagnosis and are 18+ years old. Submit prior authorization requests before prescribing or billing for Sinuva treatments to avoid claim denials.