MedicaidPrior AuthMedium impact
Kalbitor (ecallantide) (New)
Humana·IN · Allergy & Immunology, Emergency Medicine, Internal Medicine·Medicaid
We identified it
Jul 21, 2026
Summary
Humana has issued a new Prior Authorization policy for Kalbitor (ecallantide) affecting Medicaid-Indiana members. This is a medication used for hereditary angioedema (HAE) treatment that now requires prior authorization before claims will be processed for Indiana Medicaid beneficiaries.
Action Required
Immediately: Billing team must implement prior authorization requirement for Kalbitor (ecallantide) claims for all Indiana Medicaid members. (1) Contact Humana at the provided source URL to obtain prior authorization submission procedures and requirements. (2) Update billing software to flag all Kalbitor prescriptions/claims for Indiana Medicaid requiring prior auth approval before submission. (3) Notify prescribing providers (likely emergency medicine, allergy-immunology, or internal medicine specialists treating HAE patients) that prior authorization is now mandatory. (4) Train front-desk and billing staff to request prior auth documentation from providers before processing claims. Claims submitted without prior authorization will be denied by Humana for Indiana Medicaid members.