MedicaidPrior AuthMedium impact
Libtayo® (cemiplimab-rwlc) (New)
Humana·LA · Oncology, Dermatology, Pulmonology·Medicaid
Effective date
Feb 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has established a new prior authorization policy for Libtayo (cemiplimab-rwlc) for Louisiana Medicaid patients, covering four cancer indications including cutaneous squamous cell carcinoma, basal cell carcinoma, and non-small cell lung cancer. All requests require prior authorization with specific criteria including monotherapy use and exclusion of patients who progressed on prior PD-1/PD-L1 inhibitors.
Action Required
Before February 1, 2026: Billing and clinical teams must establish prior authorization workflow for Libtayo (cemiplimab-rwlc) for Louisiana Medicaid patients. Update system to flag all Libtayo requests for prior auth review. Providers must document diagnosis criteria, treatment history, and monotherapy status. Create checklist for the four covered indications: cutaneous squamous cell carcinoma, basal cell carcinoma, and non-small cell lung cancer. Claims will be denied without proper prior authorization.