MedicaidPrior AuthMedium impact
Unloxcyt™ (cosibelimab-ipdl) (New)
Humana·IN · Oncology, Dermatology·Medicaid
Effective date
May 1, 2026
We identified it
Jun 24, 2026
Summary
New prior authorization policy for Unloxcyt™ (cosibelimab-ipdl), a cancer immunotherapy drug for cutaneous squamous cell carcinoma, effective May 1, 2026 for Indiana Medicaid patients. Prior authorization required with specific criteria including locally advanced/metastatic disease and inability to receive curative surgery/radiation.
Action Required
Before May 1, 2026: Billing team must update prior authorization processes for Unloxcyt™ (cosibelimab-ipdl) for Indiana Medicaid patients. Ensure providers document: 1) cutaneous squamous cell carcinoma diagnosis, 2) locally advanced or metastatic disease, 3) patient not candidate for curative surgery/radiation, 4) drug used as monotherapy, and 5) no prior disease progression on PD-1/PD-L1 inhibitors. Initial approvals limited to 6 months. Claims will be denied without proper prior authorization.