Medicare AdvantagePrior AuthMedium impact
Palynziq™ (pegvaliase-pqpz) Injection (Revised)
Humana·KY, SC · Genetics, Internal Medicine·Medicaid
We identified it
Jul 22, 2026
Summary
This is a revised Prior Authorization policy for Palynziq™ (pegvaliase-pqpz) Injection affecting Medicare and Medicaid members in Kentucky and South Carolina. The policy was updated 1 day ago and requires immediate review to identify specific changes from the previous version and implement any new authorization requirements or billing procedures.
Action Required
Immediately: Billing and clinical teams must access the full policy document at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a5867c0 to identify specific changes from the prior version. Compare the revised policy against current authorization protocols for Palynziq in Kentucky and South Carolina Medicaid plans. Update prior authorization workflows, templates, and staff training based on any new requirements identified. Document the revision date (1 day old) in your policy tracking system. Contact Humana directly if clarification is needed on what specifically changed in this revision. Communicate updates to providers prescribing Palynziq to ensure compliance with new requirements.