MedicaidPrior AuthLow impact
Kalbitor (ecallantide) (New)
Humana·IN · Allergy & Immunology, Emergency Medicine·Medicaid
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has implemented a new prior authorization policy for Kalbitor (ecallantide), a medication used to treat acute hereditary angioedema attacks. The policy requires extensive documentation including lab values, specialist treatment, and specific diagnostic criteria before approval.
Action Required
Before October 1, 2025: Billing team must ensure prior authorization is obtained for all Kalbitor (ecallantide) prescriptions for Indiana Medicaid patients. Providers treating hereditary angioedema must document all required criteria including C4 levels, C1 inhibitor levels, C1q levels, specialist treatment by allergist/immunologist, and rule out of other causes. Claims without prior authorization will be denied.