MedicaidPrior AuthMedium impact
Benzodiazepine Limited Days Supply (Revised)
Humana·IN · Psychiatry, Neurology, Family Medicine +3 more·Medicaid
Effective date
Jul 1, 2024
We identified it
Jun 24, 2026
Summary
Humana's Indiana Medicaid now requires prior authorization for benzodiazepine prescriptions exceeding 15-day supplies for new long-term therapy patients. Coverage is limited to 30 days total every 90 days unless specific medical conditions are met.
Action Required
Immediately: Billing team must identify Indiana Medicaid patients receiving benzodiazepines (alprazolam, clonazepam, diazepam, lorazepam, etc.) who are starting long-term therapy. Providers must obtain prior authorization for any prescriptions exceeding 15-day supply or document qualifying conditions (cancer, seizure disorder, catatonia, terminal illness, spasticity with CNS disorders, or akathisia). Update patient records to track benzodiazepine therapy history within past 180 days to determine if prior auth is required.