MedicaidPrior AuthMedium impact
Exdensur™ (depemokimab-ulaa) (New)
Humana·IN·Medicaid
We identified it
Jul 1, 2026
Summary
Humana Medicaid (Indiana) has implemented a new Prior Authorization policy for Exdensur™ (depemokimab-ulaa), a newly approved medication. Billing teams must obtain prior authorization before claims submission to avoid denials. Specific clinical criteria and documentation requirements are contained in the full policy document.
Action Required
Immediately: Billing team must implement prior authorization requirement for Exdensur™ (depemokimab-ulaa) for all Humana Medicaid Indiana members. 1) Update billing software to flag claims for this medication and route to prior auth team. 2) Obtain detailed policy criteria by accessing the full policy at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a56a5bf. 3) Establish authorization workflow with providers to collect required clinical documentation before dispensing or administering. 4) Notify prescribers and pharmacy staff of the prior auth requirement. 5) Train front desk and verification staff to communicate authorization needs to patients. Failure to obtain prior authorization will result in claim denials.