MedicaidPrior AuthMedium impact
Erbitux (cetuximab) (New)
Humana·IN · Oncology, Hematology·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has implemented a new prior authorization policy for Erbitux (cetuximab) IV infusions effective February 1, 2026, for Indiana Medicaid members. The policy requires specific genetic testing documentation and combination therapy criteria for colorectal and head/neck cancers.
Action Required
Before February 1, 2026: Billing team must update prior authorization procedures for Erbitux (cetuximab) IV infusions for Indiana Medicaid patients. Ensure providers document required genetic testing (BRAF V600E, KRAS G12C, wild-type RAS status) and combination therapy details before administering. Update encounter forms to capture genetic mutation status and prior therapy history. Claims will require prior authorization approval or will be denied.