MedicaidPrior AuthMedium impact
Zycubo® (copper histidinate) Powder for Injection (New)
Humana·LA · Pediatrics, Neurology, Genetics +1 more·Medicaid
Effective date
May 1, 2026
We identified it
Jun 25, 2026
Summary
Humana Medicaid Louisiana has established a new prior authorization policy for Zycubo® (copper histidinate) Powder for Injection, effective May 1, 2026. Coverage is limited to pediatric patients (up to 17 years) with genetically confirmed Menkes disease (ATP7A gene mutations). Providers must obtain prior authorization before dispensing and attest to genetic confirmation of diagnosis.
Action Required
By April 30, 2026: (1) Billing team must implement prior authorization workflow for Zycubo claims in the Humana Medicaid Louisiana system. (2) Update claim submission processes to require genetic confirmation documentation (ATP7A gene mutation testing results) with all requests. (3) Configure billing system to restrict coverage to members age 17 and younger only; flag and deny claims for patients age 18+. (4) Providers must attest to genetically confirmed Menkes disease diagnosis on all prior authorization requests—claims without this attestation will be denied. (5) Visit www.humana.com/PAL to obtain applicable medical/procedural coding information for claim submission. (6) Front desk and billing staff should educate prescribing providers about the genetic confirmation requirement to avoid claim rejections.