MedicaidPrior AuthMedium impact
Soliris® (eculizumab) (Revised)
Humana·KY · Hematology, Neurology, Nephrology +1 more·Medicaid
Effective date
Jul 24, 2024
We identified it
Jun 24, 2026
Summary
Humana revised their prior authorization policy for Soliris (eculizumab) effective July 24, 2024, affecting Medicaid Kentucky plans. This is a high-priority update for practices treating rare blood disorders, myasthenia gravis, and neurological conditions requiring this specialty medication.
Action Required
Immediately: Review and update prior authorization procedures for Soliris (eculizumab) for Kentucky Medicaid patients. Ensure providers document specific diagnostic criteria including lab values, antibody tests, and treatment history as outlined in the revised policy. Verify meningococcal vaccination requirements are met before treatment initiation. Claims without proper prior authorization will be denied.