New and revised pharmacy and medical coverage policies available

Humana’s medical and pharmacy coverage policies are based on evidence published in peer-reviewed medical literature, technology assessments obtained from independent medical research organizations, evidence-based consensus statements, and evidence-based guidelines from nationally recognized professional healthcare organizations.

Information about medical and pharmacy coverage policies can be found at Humana for Healthcare Providers by selecting “Medical and pharmacy coverage policies” under “Resources.” Policies can be reviewed by name or revision date. Users also may search for a particular policy using the search box. More detailed information can be found under “Helpful Links” by reviewing “How to Read a Medical and Pharmacy Coverage Policy” and “Understanding the Medical and Pharmacy Coverage Policy Development Process.”

Recent changes to medical and pharmacy coverage policies are listed below:

• Azedra® (iobenguane I 131)
• Calcitonin gene-related peptide (CGRP) inhibitors
• Epidiolex (cannabidiol)
• Mulpleta (lusutrombopag)
• Nivestym (filgrastim-aafi)
• Nocdurna (desmopressin)
• Onpattro (patisiran)
• Orilissa (elagolix)
• Poteligeo (mogamulizumab-kpkc)
• Takhzyro (lanadelumab)
• Tibsovo (ivosidenib)

• No new medical coverage policies

• No revised pharmacy coverage policies

• Cardiovascular Disease (CVD) Risk Testing
• Gene Expression Profiling
• Glaucoma Emerging Treatments
• Hyperthermia Treatment for Cancer (local, regional and whole body)
• Multianalyte Assays with Algorithmic Analyses (MAAAs)
• Neuroablative Techniques for Chronic Pain
• Noninvasive Home Ventilators
• Ocular Surface Disease-Diagnosis and Treatment
• Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)
• Serological and Fecal Testing for Inflammatory Bowel Disease (IBD)