MedicaidPrior AuthMedium impact
Polivy™ (polatuzumab vedotin-piiq) (New)
Humana·LA · Oncology, Hematology·Medicaid
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has implemented a new prior authorization policy for Polivy (polatuzumab vedotin-piiq), a cancer treatment for diffuse large B-cell lymphoma. This affects Louisiana Medicaid patients requiring this specialty oncology drug, with specific clinical criteria that must be met before approval.
Action Required
Before June 1, 2026: Oncology billing team must establish prior authorization workflow for Polivy (polatuzumab vedotin-piiq) for Louisiana Medicaid patients. Ensure providers document diagnosis of diffuse large B-cell lymphoma, prior treatment history, combination therapy details, and absence of exclusion criteria. Update EMR templates to capture required clinical criteria. Claims will be denied without proper prior authorization.