MedicaidPrior AuthMedium impact
LAMZEDE® (velmanase alfa-tycv) (New)
Humana·OH · Internal Medicine, Genetics, Pediatrics·Medicaid
We identified it
Jul 1, 2026
Summary
Humana Ohio Medicaid has implemented a new Prior Authorization policy for LAMZEDE® (velmanase alfa-tycv), an enzyme replacement therapy for lysosomal acid lipase deficiency. Billing teams must obtain prior authorization before claims submission for Ohio Medicaid members to avoid denial.
Action Required
Immediately: Billing team must implement prior authorization workflow for LAMZEDE® (velmanase alfa-tycv) for all Ohio Medicaid members. Contact Humana Ohio Medicaid at the number listed in the policy before submitting claims. Add LAMZEDE to the Prior Auth requirement checklist in billing software. Clinical staff should verify member eligibility and coverage before infusion. Without prior authorization, claims will be denied by Humana Ohio Medicaid.