MedicaidPrior AuthHigh impact
Bevacizumab products (Revised)
Humana·OH · Oncology, Ophthalmology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Ohio Medicaid has updated prior authorization requirements for bevacizumab products (Avastin, Mvasi, Zirabev, etc.) effective January 1, 2026. The policy establishes preferred biosimilars (Mvasi and Zirabev) and requires documentation of intolerance or contraindication to use other bevacizumab products for oncology indications.
Action Required
By January 1, 2026: Billing team must update prior authorization workflow for all bevacizumab products for Ohio Medicaid patients. For oncology uses, document medical necessity showing intolerance or contraindication to Mvasi or Zirabev before prescribing Avastin, Alymsys, Jobevne, or Vegzelma. Update encounter forms to capture required criteria for each indication including disease stage, combination therapies, and exclusion criteria. Claims without proper prior authorization will be denied.