MedicaidPrior AuthMedium impact
Vabysmo® (faricimab-svoa) (New)
Humana·IN · Ophthalmology·Medicaid
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid (Indiana) has introduced a new prior authorization policy for Vabysmo (faricimab-svoa) intravitreal injections used to treat retinal conditions. Prior authorization is required for all three covered indications, with bevacizumab failure or contraindication as a prerequisite for approval.
Action Required
By December 1, 2025: Billing team must implement prior authorization requirements for all Vabysmo (faricimab-svoa) claims for Indiana Medicaid patients. Providers must document bevacizumab contraindication, intolerance, or lack of clinical response before prescribing Vabysmo. Update billing system to flag these cases and ensure prior auth is obtained before treatment. Claims will be denied without proper authorization.