MedicaidPrior AuthMedium impact
Gazyva® (obinutuzumab) (New)
Humana·IN · Hematology, Oncology, Rheumatology·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has established a new prior authorization policy for Gazyva (obinutuzumab) for Indiana Medicaid members, covering three conditions: chronic lymphocytic leukemia, follicular lymphoma, and lupus nephritis. This policy requires specific diagnostic criteria and combination therapy requirements to be met before approval.
Action Required
Before February 1, 2026: Billing team must update prior authorization workflows for Gazyva (obinutuzumab) prescriptions for Indiana Medicaid members. Ensure providers document specific diagnostic criteria and combination therapy requirements for chronic lymphocytic leukemia, follicular lymphoma, and lupus nephritis cases. Submit prior authorization requests through appropriate Humana channels before administering treatment to avoid claim denials.