MedicaidPrior AuthMedium impact
Valstar (valrubicin) (New)
Humana·OH · Oncology, Urology·Medicaid
Effective date
May 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has implemented a new prior authorization policy for Valstar (valrubicin) intravesical solution, used to treat bladder cancer. Prior authorization will be required for all prescriptions of this medication with specific clinical criteria that must be met.
Action Required
Before May 1, 2026: Providers treating bladder cancer patients must obtain prior authorization from Humana Medicaid Ohio before prescribing Valstar (valrubicin). Ensure patients meet all three criteria: recurrent/persistent bladder CIS, BCG therapy failure/intolerance/contraindication, and not a candidate for immediate cystectomy. Verify no exclusions exist (active UTI, perforated bladder, small bladder capacity). Claims will be denied without proper prior authorization.