MedicaidPrior AuthMedium impact
Imaavy intravenous solution (nipocalimab-aahu) (New)
Humana·IN · Infectious Disease, Rheumatology, Neurology·Medicaid
We identified it
Aug 4, 2026
Summary
Humana Medicaid-Indiana has issued a new Prior Authorization policy for Imaavy intravenous solution (nipocalimab-aahu), a newly covered medication. Billing teams must implement prior authorization requirements before submitting claims for this drug to avoid denials on Indiana Medicaid members.
Action Required
Immediately: Billing team must obtain prior authorization from Humana before dispensing or billing Imaavy intravenous solution (nipocalimab-aahu) for Indiana Medicaid members. Access the full policy at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a593624 to review specific approval criteria, required documentation, and submission procedures. Update billing system alerts and provider communication to flag this medication as requiring prior auth. Claims submitted without prior authorization will be denied. Coordinate with pharmacy/infusion providers and clinical staff to ensure prior auth requests are initiated before treatment.