MedicaidPrior AuthLow impact
Bizengri (zenocutuzumab-zbco) (New)
Humana·OH · Oncology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio is introducing a new prior authorization policy for Bizengri (zenocutuzumab-zbco), a specialized cancer treatment for NRG1 gene fusion positive non-small cell lung cancer and pancreatic adenocarcinoma. The policy requires specific diagnostic criteria and treatment history documentation for approval.
Action Required
Before January 1, 2026: Billing team must update prior authorization workflows for Bizengri (zenocutuzumab-zbco) infusions. Ensure providers document NRG1 gene fusion positive status, advanced/metastatic disease stage, and prior systemic therapy history before submitting requests. Add reminders to oncology encounter forms for required documentation. Claims will be denied without proper prior authorization.