MedicaidPrior AuthHigh impact
IVIG (immune globulin) (Revised)
Humana·IN · Allergy & Immunology, Hematology, Oncology +4 more·Medicaid
Effective date
Jul 1, 2024
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has updated their IVIG (immune globulin) prior authorization policy effective July 1, 2024, establishing specific preferred products and coverage criteria for 24 different conditions including primary immunodeficiency, chronic leukemia, and various autoimmune disorders. The policy requires prior authorization for all IVIG products with preference given to specific brands like Flebogamma DIF, Gammagard, and Privigen.
Action Required
Immediately: Billing and clinical teams must implement prior authorization requirements for all IVIG treatments for Humana Medicaid Indiana members. Update billing system to flag IVIG orders requiring prior auth. Providers must verify patient diagnosis meets specific criteria outlined in policy and document preferred product use (Flebogamma DIF, Gammagard, Gammagard S/D, Gammaked, Gamunex-C, Hizentra, Octagam, Privigen, Xembify). For non-preferred products, document prior therapy or intolerance with preferred products. Failure to obtain prior authorization will result in claim denials.