MedicaidPrior AuthLow impact
Elaprase® (idursulfase) (New)
Humana·IN · Genetics, Pediatrics, Endocrinology·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Indiana Medicaid has implemented a new prior authorization policy for Elaprase (idursulfase), a rare enzyme replacement therapy for Hunter syndrome. Providers must obtain prior authorization with documented Hunter syndrome diagnosis before prescribing this medication.
Action Required
Before October 1, 2025: Billing team must update prior authorization workflow to include Elaprase (idursulfase) for Indiana Medicaid patients. Providers must document Hunter syndrome (Mucopolysaccharidosis II) diagnosis before prescribing. Claims without prior authorization will be denied.