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Humana Medical Policy Updates – December 2018
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December 2018 Humana Medical Policy Updates;
- Ablation Techniques and Extracorporeal Shock Wave Therapy for Musculoskeletal Indications and Soft Tissue Wounds
- Aliqopa™ (copanlisib)
- Anzemet® (dolasetron)
- Arcalyst® (rilonacept)
- Atgam® (antithymocyte immune globulin, equine)
- Autism Spectrum Disorders (ASD) Diagnosis and Treatment
- Auvi‐Q® (epinephrine injection)
- Azopt® (brinzolamide ophthalmic suspension) 1%
- Basaglar® (insulin glargine)
- Benign Prostatic Hyperplasia (BPH) Treatments
- Biguanide Agents
- Biofeedback
- Brachytherapy
- Breast Imaging
- Cardiac Monitoring Devices
- Cardioverter Defibrillators/Cardiac Resynchronization Therapy
- Carpal Tunnel Syndrome (CTS) Surgical Treatments
- Chest Wall Deformities (Pectus Excavatum/ Carinatum and Poland Syndrome) Treatments
- Cinryze (C1 esterase inhibitor, human)
- Cognitive Rehabilitation
- Colorectal Cancer Screening
- Copiktra™ (duvelisib)
- Coronary Artery Calcium Scoring and Coronary Computed Tomography Angiography
- Cosmetic Surgery, Reconstructive Surgery, Scar Revision
- Cryoablation
- Cryoablation
- Deep Brain Stimulation (DBS) and Cortical Stimulation
- Dupixent® (dupilumab) Injection
- Formulary Tier Exception
- Fusilev® (levoleucovorin)
- Genetic Testing for Disease Risk
- Genetic Testing for Disease Risk
- Glatiramer Products (Copaxone, Glatopa, glatiramer)
- Gocovri™ (amantadine)
- High Risk Medications (HRM) in the Elderly
- Humira (adalimumab)
- Ilaris® (canakinumab)
- Iluvien® (fluocinolone acetonide intravitreal implant)
- Jakafi® (ruxolitinib)
- Lexette™ (halobetasol) Topical Foam
- Libtayo® (cemiplimab‐rwlc)
- Lumoxiti™ (moxetumomab pasudotox‐tdfk)
- Mepsevii™ (vestronidase alfa‐vjbk)
- Natpara® (parathyroid hormone)
- Non‐Formulary Exceptions
- Noxafil® (posaconazole)
- Nuedexta® (dextromethorphan and quinidine)
- Nuedexta® (dextromethorphan and quinidine)
- Nulojix® (belatacept)
- Onfi® (clobazam)
- Onivyde ® (liposomal irinotecan)
- Onpattro™ (patisiran)
- Ophthalmic Prostaglandins
- Osphena® (ospemifene)
- Otrexup ™ (methotrexate injection)
- Lartruvo™ (olaratumab)
- Tracleer (bosentan) tablet for oral suspension
- Limited Day Supply
- Attention Deficit Hyperactivity Disorder (ADHD) – Diagnosis and Treatment
- Zontivity® (vorapaxar)
- Pharmacogenomics and Companion Diagnostics
- Plantar Fasciitis Treatments
- Portrazza™ (necitumumab)
- Portrazza™ (necitumumab)
- Qbrexza™ (glycopyrronium)
- Rapid‐Acting Fentanyl (Abstral®, Actiq®, Fentora®, Lazanda®, Subsys®)
- Rayaldee® (calcifediol)
- Savaysa® (edoxaban)
- Sernivo™ (betamethasone dipropionate) Spray
- Sernivo™ (betamethasone dipropionate) Spray
- Siklos® (hydroxyurea)
- Simbrinza™ (brinzolamide/brimonidine ophthalmic suspension)
- Simponi® (golimumab)
- Simponi® (golimumab)
- Somatuline Depot® (lanreotide)
- Somatuline® Depot (lanreotide)
- Talzenna™(talazoparib)
- Tegsedi (inotersen)
- Thymoglobulin® (anti‐thymocyte globulin [rabbit])
- Topical Psoriasis Agents
- Topical Psoriasis Agents
- Tracleer (bosentan) tablet for oral suspension
- Venclexta™ (venetoclax)
- Vizimpro® (dacomitinib)
- Yondelis® (trabectedin)
- Zaltrap® (ziv‐aflibercept)
- Zilretta™ (triamcinolone acetonide extended‐release injectable suspension)
- ZTlido™ (lidocaine topical system)
Click here to view the Humana Medical Policy Updates Updates »
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