MedicaidPrior AuthLow impact
Panhematin® (heme for injection) intravenous solution (Revised)
Humana·OH · Hematology, Internal Medicine·Medicaid
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has implemented a prior authorization policy for Panhematin (heme for injection) effective January 1, 2025. The policy requires specific criteria to be met including confirmed diagnosis via urine testing and failed/inadequate carbohydrate therapy before approval for acute intermittent porphyria treatment.
Action Required
By January 1, 2025: Billing team must ensure prior authorization is obtained for all Panhematin injections for Ohio Medicaid patients. Verify patients meet all three criteria: menstrual cycle-related attacks, confirmed PBG urine testing, and failed/inadequate carbohydrate therapy. Visit www.humana.com/PAL for specific medical coding information. Claims will be denied without proper prior authorization.