Medicare AdvantagePrior AuthLow impact
Veopoz (pozelimab-bbfg) (Revised)
Humana·Gastroenterology, Genetics, Pediatrics +1 more·Medicare Advantage
Effective date
Jan 24, 2024
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Veopoz (pozelimab-bbfg) injection for treatment of CHAPLE disease. Members must have confirmed CD55 loss of function mutation by genetic testing and be at least 1 year old to qualify for coverage.
Action Required
Immediately: Billing team must obtain prior authorization from Humana before administering Veopoz (pozelimab-bbfg) injections for Medicare Advantage members. Visit www.humana.com/PAL for specific medical coding information and preauthorization requirements. Ensure patients meet criteria: confirmed CHAPLE disease diagnosis with CD55 genetic testing and age 1+ years. Claims will be denied without prior authorization.