MedicaidPrior AuthMedium impact
Berinert (C1 esterase inhibitor, human) (New)
Humana·IN · Allergy & Immunology, Emergency Medicine, Internal Medicine·Medicaid
We identified it
Jul 21, 2026
Summary
Humana Medicaid has implemented a new Prior Authorization policy for Berinert (C1 esterase inhibitor, human) for Indiana members. Billing teams must obtain prior authorization before submitting claims for this medication to avoid denials.
Action Required
Immediately: Billing team must implement prior authorization requirement for Berinert (C1 esterase inhibitor, human) for all Humana Medicaid—Indiana claims. Update billing system rules to flag claims requiring prior auth before submission. Notify providers and clinical staff to obtain authorization before prescribing or administering. Link staff to policy at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a5847fa. Claims submitted without prior authorization will be denied.