Humana Updates Commercial Preauthorization and Notification List

On July 20, 2017, Humana will update its preauthorization and notification list for all commercial plans.

Changes to commercial preauthorization requirements include:

  • Expansion of medication preauthorization requirements to include Aloxi, Feiba NF, Granix, Mozobil, Nuwiq, NovoEight, Kanuma, Nucala, Strensiq, Tretten and Vidaza. All other blood-clotting factors still require preauthorization.
  • Additions to the list of drugs that require site-of-care review for commercial fully insured plans and exchanges.

Important note: If a health care provider does not obtain preauthorization for a service, it could result in payment denials for the health care provider or reduced benefits for the member. Services or medications provided without preauthorization may be subject to retrospective medical necessity review. We recommend that a health care provider making a specific request for services or medications verify benefits and authorization requirements with Humana prior to providing services.

Find more details here.