MedicaidPrior AuthMedium impact
Herceptin Hylecta (trastuzumab and hyaluronidase- oysk) (Revised)
Humana·IN · Oncology, Hematology·Medicaid
Effective date
Mar 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Indiana has established new prior authorization requirements for Herceptin Hylecta (subcutaneous trastuzumab) for HER2-positive breast cancer treatment. Patients must have tried and failed or shown intolerance to preferred alternatives (Kanjinti or Trazimera) before approval.
Action Required
By March 1, 2026: Billing team must implement prior authorization requirements for Herceptin Hylecta claims for Humana Medicaid Indiana members. Verify patients have HER2-positive breast cancer diagnosis and document prior treatment with or intolerance to Kanjinti or Trazimera. Visit www.humana.com/PAL for specific medical billing codes. Claims without proper prior authorization will be denied.