MedicaidPrior AuthHigh impact
Bevacizumab products (Revised)
Humana·LA · Oncology, Ophthalmology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Louisiana Medicaid has updated prior authorization requirements for bevacizumab products (Avastin, Mvasi, Zirabev, etc.) effective January 1, 2026. The policy establishes specific criteria for oncology and ophthalmology indications, with preferred biosimilars Mvasi and Zirabev required first before other formulations for cancer treatments.
Action Required
Before January 1, 2026: Update prior authorization workflows for all bevacizumab products in Louisiana Medicaid patients. Billing team must ensure ophthalmology claims for macular degeneration/diabetic macular edema obtain pharmacy prior auth. Oncology providers must document trial/contraindication to Mvasi or Zirabev before prescribing Avastin, Alymsys, Jobevne, or Vegzelma. Update EMR templates to include required criteria documentation for each covered indication.