MedicaidPrior AuthHigh impact
Bevacizumab products (Revised)
Humana·IN · Oncology, Ophthalmology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Indiana Medicaid has updated prior authorization requirements for bevacizumab products (Avastin, Mvasi, Zirabev, etc.) used to treat various cancers and eye conditions. The policy establishes specific coverage criteria for each indication and requires step therapy with preferred biosimilars for oncology uses.
Action Required
By January 1, 2026: Billing and clinical teams must implement prior authorization processes for all bevacizumab products for Indiana Medicaid patients. Update systems to require documentation of specific clinical criteria for each indication (cancer stage, combination therapies, contraindications to preferred products). Ensure providers document intolerance or contraindication to Mvasi or Zirabev before prescribing Avastin, Alymsys, Jobevne, or Vegzelma for oncology patients. Claims will be denied without proper prior authorization.