MedicaidPrior AuthMedium impact
Gazyva® (obinutuzumab) (New)
Humana·LA · Hematology, Oncology, Rheumatology·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
New prior authorization policy for Gazyva (obinutuzumab) infusion covering three conditions: chronic lymphocytic leukemia, follicular lymphoma, and lupus nephritis for Louisiana Medicaid patients. Specific combination therapy requirements and exclusion criteria must be met for approval.
Action Required
By February 1, 2026: Billing team must implement prior authorization requirements for Gazyva (obinutuzumab) infusions for Louisiana Medicaid patients. Update billing system to flag these cases and create workflow to verify diagnosis (CLL, follicular lymphoma, or lupus nephritis), combination therapy requirements, and absence of disease progression. Train staff on specific criteria for each indication including required combination medications and exclusions.