MedicaidPrior AuthMedium impact
Herceptin Hylecta (trastuzumab and hyaluronidase- oysk) (Revised)
Humana·LA · Oncology·Medicaid
Effective date
Mar 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has established prior authorization requirements for Herceptin Hylecta (subcutaneous trastuzumab) for HER2-positive breast cancer treatment. Patients must have tried or be intolerant to Kanjinti or Trazimera first, and meet specific combination therapy criteria.
Action Required
Before March 1, 2026: Billing team must implement prior authorization workflow for Herceptin Hylecta for Louisiana Medicaid patients. Verify patients have HER2-positive breast cancer diagnosis, document intolerance or prior treatment with Kanjinti or Trazimera, and confirm appropriate combination therapy regimens. Obtain prior authorization before treatment to avoid claim denials.