Medicare AdvantageAdministrativeLow impact
Thrombate III® [Antithrombin III (Human)] (Revised)
Humana·FL, KY, VA · Hematology, Internal Medicine, OB-GYN·Medicaid
Effective date
Jan 1, 2018
We identified it
Jun 25, 2026
Summary
This is a routine policy revision for Thrombate III (Antithrombin III Human) effective January 1, 2018, with the most recent update dated August 27, 2025. The policy maintains prior authorization requirements for Medicaid members in Florida, Kentucky, and Virginia (plus Medicare) with hereditary antithrombin deficiency. No substantive coverage changes are documented in this revision—it appears to be a standard periodic review update.
Action Required
No immediate action required. This is a routine policy maintenance update with no new prior authorization requirements, billing code changes, or coverage modifications documented. Billing teams should verify this is the current version in the Humana system before processing Thrombate III claims. For new Thrombate III requests: Confirm member has documented hereditary antithrombin deficiency diagnosis and that the medication will be used for treatment or prevention of thromboembolism (including peri-operative or peri-partum prevention). Route claims through standard prior authorization process for affected states.