MedicaidPrior AuthHigh impact
Opioid Utilization Program - Concurrent Use of Opioids and Benzodiazepines (COB) edits (Revised)
Humana·IN · Pain Management, Family Medicine, Internal Medicine +2 more·Medicaid
Effective date
Jul 1, 2024
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana now requires prior authorization when members use opioids and benzodiazepines concurrently for more than 7 days within a 180-day period. Prescribers must document medical necessity, patient education about risks, and coordination with other providers to obtain coverage approval.
Action Required
Immediately: Alert prescribers that concurrent opioid and benzodiazepine therapy exceeding 7-day overlap requires prior authorization for Humana Medicaid Indiana members. Prescribers must document: indication for both medications, previous therapy attempts, INSPECT report review, patient risk education, and consultation with other prescribers. Update EMR templates to include required documentation elements. Claims without prior auth will be denied.