On Jan. 1, 2019, Humana will update its preauthorization and notification lists, opens new window for all commercial fully insured, Medicare Advantage (MA) plans and dual Medicare-Medicaid plans.
Preauthorization will be required for the following medical services:
- Ablation (bone, liver, kidney, prostate)
- Capsule endoscopy
- Decompression of peripheral nerve, i.e., carpal tunnel surgery (required for patients with Humana commercial coverage only)
- EGD endoscopy (required for patients 59 and younger with Humana commercial coverage only, includes site-of-service evaluation)
- Gastric pacing (required for patients with Humana commercial coverage only)
- Noninvasive home ventilators
- Peripheral revascularization (atherectomy, angioplasty)
- Thyroid surgeries (thyroidectomy and lobectomy)
New medication preauthorization requirements include all medications noted with an asterisk (*) on the preauthorization lists posted on Humana.com/PAL.
Find all the details here, opens new window