MedicaidPrior AuthMedium impact
Papzimeos™ (zopapogene imadenovec-drba) (New)
Humana·IN·Medicaid
We identified it
Jul 2, 2026
Summary
Humana Medicaid–Indiana has issued a new prior authorization policy for Papzimeos™ (zopapogene imadenovec-drba), a gene therapy product. Billing teams must implement prior authorization requirements before submitting claims for this drug to avoid denials. The policy is effective immediately given its 1-day age.
Action Required
Immediately: Billing team must obtain prior authorization from Humana Medicaid–Indiana before submitting any claims for Papzimeos™ (zopapogene imadenovec-drba). Update billing system to flag this drug for mandatory prior auth review. Notify prescribing providers that this drug requires pre-approval. Reference the full policy at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a56d8bc for specific authorization criteria, documentation requirements, and medical necessity guidelines. Claims submitted without prior authorization will be denied.