Humana Updates Preauthorization and Notification Lists for 2019

On Jan. 1, 2019, Humana will update its preauthorization and notification lists 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.