High impact
Breyanzi® (lisocabtagene maraleucel) (Revised)
Humana·Effective Aug 26, 2026
Humana Louisiana Medicaid has revised its Breyanzi® (lisocabtagene maraleucel) pharmacy coverage policy effective August 26, 2026. The policy establishes prior authorization requirements for this CAR-T cell therapy across six hematologic malignancies (Large B-cell Lymphoma 3L/2L, CLL/SLL, Follicular Lymphoma, Mantle Cell Lymphoma, and Marginal Zone Lymphoma) with specific clinical criteria, exclusions, and a lifetime maximum of one dose per member. Billing teams must implement prior authorization workflows and verify member eligibility against defined clinical criteria before claims submission.