MedicaidPrior AuthMedium impact
Inlexzo (gemcitabine intravesical system) (New)
Humana·LA · Urology, Oncology·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Louisiana has established a new prior authorization policy for Inlexzo (gemcitabine intravesical system), effective February 1, 2026, for treatment of BCG-unresponsive non-muscle invasive bladder cancer. Prior authorization will be required with specific criteria including documented carcinoma in situ, BCG-unresponsive disease, and patient ineligibility for cystectomy.
Action Required
Before February 1, 2026: Billing team must update prior authorization systems to require approval for Inlexzo (gemcitabine intravesical system) for Louisiana Medicaid patients. Providers must document BCG-unresponsive non-muscle invasive bladder cancer with carcinoma in situ, adequate BCG therapy history, and patient's cystectomy eligibility status. Visit www.humana.com/PAL for medical billing codes. Claims without prior authorization will be denied.