MedicaidPrior AuthMedium impact
Anktiva (nogapendekin alfa inbakicept-pmln) (New)
Humana·LA · Oncology, Urology·Medicaid
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has established a new prior authorization policy for Anktiva (nogapendekin alfa inbakicept-pmln), a new cancer drug for treating BCG-unresponsive non-muscle invasive bladder cancer. The policy requires strict criteria including age 18+, documented carcinoma in situ, BCG-unresponsive disease, and concurrent use with BCG therapy.
Action Required
Before June 1, 2026: Billing team must implement prior authorization requirements for Anktiva (nogapendekin alfa inbakicept-pmln) for Humana Medicaid Louisiana members. Update billing system to flag this medication and create workflow to verify all 5 criteria are met before treatment. Providers must document BCG-unresponsive NMIBC with carcinoma in situ, adequate BCG therapy history, and cystectomy ineligibility. Claims will be denied without proper prior authorization.